title: Role of the VEGF 936 gene polymorphism and VEGF-A levels in the late-term arteriovenous fistula thrombosis in patients undergoing hemodialysis.
abstract: OBJECTIVE
  Vascular access is vital for hemodialysis patients. A major factor that facilitates arteriovenous (AV) fistula failure is stenosis and thrombosis due to intimal hyperplasia developing in the venous segment of AV fistula. It has been reported that VEGF accelerated re-endothelialization, reduction in intimal thickening, and/or mural thrombus formed in the injured vascular structures. In this study, we aimed to identify the effect of the VEGF 936 gene polymorphism and vascular endothelial growth factor-A (VEGF-A) levels in the late period of AV fistula loss in hemodialysis patients.
  
  
  METHODS
  The study was carried out with a patient group of 42 individuals who experienced two or more fistula thrombosis in the late period after the AV fistula operation and also a control group of 38 patients who have not had any AV fistula thrombosis history for 3 years or more. All participants were assessed for VEGF-936C/T gene polymorphism and VEGF-A levels.
  
  
  RESULTS
  VEGF-936C/T genotypes were determined in the large proportion in the control group (31.6 %), while VEGF-936C/C genotypes were determined in a large proportion in the patient group (90.5 %). Individuals carrying the VEGF-936C/C genotype had an increased risk of 5.54 for getting AV fistula thrombosis. The VEGF-A levels of patient group (27.3 ± 43.5 pg/ml) were significantly lower than those of the control group (70.7 ± 53.1 pg/ml).
  
  
  CONCLUSIONS
  There is an increased risk of AV fistula thrombosis in individuals carrying the VEGF-936C/C genotype. The other renal replacement modalities should be considered in patients with this genotype. As a result, it will be possible to prevent the morbidity and mortality due to fistula failure.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Cumhuriyet University, 58140, Sivas, Turkey.
authors.forename: Ferhan
authors.initials: F
authors.lastname: Candan
authors.forename: Gürsel
authors.initials: G
authors.lastname: Yildiz
authors.forename: Mansur
authors.initials: M
authors.lastname: Kayataş
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D006435:Renal Dialysis; D013927:Thrombosis / Q000209:etiology* / Q000235:genetics; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000097:blood* / Q000235:genetics*
chemical_list: D042461:Vascular Endothelial Growth Factor A
references.citation: J Nephrol. 2007 Mar-Apr;20(2):141-9
references.pmid: 17514618
references.citation: Adv Ren Replace Ther. 2002 Apr;9(2):74-84
references.pmid: 12085383
references.citation: Kidney Int. 2002 Mar;61(3):1011-9
references.pmid: 11849456
references.citation: Gynecol Oncol. 2010 Apr;117(1):109-16
references.pmid: 20056267
references.citation: Nephron Clin Pract. 2009;111(2):c110-6
references.pmid: 19142023
references.citation: Nephrol Dial Transplant. 2009 Nov;24(11):3468-73
references.pmid: 19561151
references.citation: Blood. 2006 Dec 15;108(13):4052-8
references.pmid: 16931622
references.citation: Nephrol Dial Transplant. 2006 Mar;21(3):721-8
references.pmid: 16311264
references.citation: J Hypertens. 2008 Sep;26(9):1875-82
references.pmid: 18698224
references.citation: Clin Biochem. 2008 Oct;41(14-15):1175-80
references.pmid: 18692491
references.citation: Semin Thromb Hemost. 2000;26(5):561-9
references.pmid: 11129413
references.citation: Arterioscler Thromb Vasc Biol. 2000 Jun;20(6):1512-20
references.pmid: 10845866
references.citation: Eur J Clin Invest. 2009 Jan;39(1):31-6
references.pmid: 19067736
references.citation: Diabetes. 2002 May;51(5):1635-9
references.pmid: 11978667
references.citation: Annu Rev Physiol. 2001;63:427-50
references.pmid: 11181962
references.citation: Oncology. 2000 Feb;58(2):169-74
references.pmid: 10705245
references.citation: J Vasc Res. 2000 Nov-Dec;37(6):443-8
references.pmid: 11146397
references.citation: Biochem Biophys Res Commun. 1996 Sep 13;226(2):324-8
references.pmid: 8806634
references.citation: Arterioscler Thromb Vasc Biol. 2008 Oct;28(10):1753-9
references.pmid: 18669887
references.citation: J Am Soc Nephrol. 2005 Apr;16(4):1108-14
references.pmid: 15728780
references.citation: Nephrology (Carlton). 2009 Oct;14(7):681-8
references.pmid: 19796028
references.citation: J Nephrol. 2005 Jan-Feb;18(1):9-20
references.pmid: 15772918
references.citation: Kidney Int. 1999 Sep;56(3):794-814
references.pmid: 10469350
references.citation: Am J Cardiol. 2003 Aug 15;92(4):400-5
references.pmid: 12914869
references.citation: Circulation. 2004 Oct 19;110(16):2444-52
references.pmid: 15477409
references.citation: J Vasc Interv Radiol. 2008 Apr;19(4):587-94
references.pmid: 18375305
references.citation: Am J Physiol Heart Circ Physiol. 2008 May;294(5):H2219-30
references.pmid: 18326810
references.citation: N Engl J Med. 1966 Nov 17;275(20):1089-92
references.pmid: 5923023
references.citation: Curr Opin Nephrol Hypertens. 2007 Nov;16(6):516-22
references.pmid: 18089964
references.citation: Kidney Int. 2007 Jan;71(1):39-43
references.pmid: 17003811
references.citation: Angiogenesis. 2003;6(4):283-7
references.pmid: 15166496
references.citation: Am J Kidney Dis. 1993 May;21(5):457-71
references.pmid: 8488813
references.citation: J Am Coll Cardiol. 2007 Mar 13;49(10):1015-26
references.pmid: 17349880
references.citation: J Vasc Surg. 2008 Feb;47(2):415-21; discussion 420-1
references.pmid: 18241764
references.citation: Nephrol Dial Transplant. 2007 May;22(5):1390-8
references.pmid: 17267534
references.citation: Nephrol Dial Transplant. 2006 Mar;21(3):715-20
references.pmid: 16249200
references.citation: J Vasc Surg. 2005 Dec;42(6):1183-9
references.pmid: 16376212
references.citation: Am J Hematol. 2007 Feb;82(2):174
references.pmid: 16917915
references.citation: Nat Clin Pract Nephrol. 2006 Sep;2(9):504-13
references.pmid: 16941043
references.citation: J Am Soc Nephrol. 2003 Oct;14(10):2645-53
references.pmid: 14514744
references.citation: FEBS Lett. 2006 May 22;580(12):2879-87
references.pmid: 16631753
references.citation: Ren Fail. 2011;33(2):169-75
references.pmid: 21332339
references.citation: Fertil Steril. 2009 Oct;92(4):1214-1220
references.pmid: 18930211