title: Influence of blood pressure variability on the life of arteriovenous fistulae in maintenance hemodialysis patients.
abstract: BACKGROUND
  Although numerous risk factors for arteriovenous fistulae (AVF) dysfunction have been identified, these risk factors do not explain all cases of AVF dysfunction. Because of the importance of blood pressure variability (BPV) in vascular injury, the predictive value of BPV for AVF dysfunction, was evaluated in this prospective cohort study.
  
  
  METHODS
  Twenty-four-hour BP monitoring at the intervals of dialysis was recorded every 3 months in 137 patients. The expression of smooth muscle actin (SMA) and the infiltration of mononuclear cells and T lymphocytes were determined by immunohistochemistry on the specimens of fistula vessels.
  
  
  RESULTS
  Eighteen patients developed AVF dysfunction. Cox proportional hazards multivariate analysis revealed a significant relationship between fistula dysfunction and daytime systolic-BPV (d-SBPV), nighttime systolic-BPV (n-SBPV), diabetes mellitus, and initial venous diameter. Patients with AVF dysfunction were observed to have increased SMA expression and more infiltration of inflammatory cells in venous walls compared with the controls. A significant correlation between SBPV and the infiltration of CD68-positive cells was observed.
  
  
  CONCLUSIONS
  Our study showed that the degrees of SBPV were significantly associated with the risk of AVF dysfunction. Potentially, the increase of SBPV will aggravate venous wall inflammation and may play a role in AVF dysfunction.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cheng
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Meng
authors.initials: M
authors.lastname: Wei
authors.forename: Dongyang
authors.initials: D
authors.lastname: Guo
authors.forename: Liweng
authors.initials: L
authors.lastname: Mo
authors.forename: Changliang
authors.initials: C
authors.lastname: Zhu
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
mesh_terms: D000199:Actins / Q000737:chemistry; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000737:chemistry; D015214:Antigens, Differentiation, Myelomonocytic / Q000737:chemistry; D001164:Arteriovenous Fistula / Q000209:etiology; D001166:Arteriovenous Shunt, Surgical; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery; D007963:Leukocytes, Mononuclear / Q000166:cytology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D012307:Risk Factors; D013601:T-Lymphocytes / Q000166:cytology; D014680:Veins; D000097382:CD68 Molecule
chemical_list: D000199:Actins; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C541116:ACTA2 protein, human; C067980:CD68 antigen, human; D000097382:CD68 Molecule
keywords: Arteriovenous fistulae; T lymphocytes; blood pressure variability; hemodialysis; mononuclear cells