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Chronic kidney disease aggravates arteriovenous fistula damage in rats

Langer, Stephan, Kokozidou, Maria, Heiss, Christian, Kranz, Jennifer, Kessler, Tina, Paulus, Niklas, Krüger, Thilo, Jacobs, Michael J., Lente, Christina and Koeppel, Thomas A. (2010) Chronic kidney disease aggravates arteriovenous fistula damage in rats KIDNEY INTERNATIONAL, 78 (12). pp. 1312-1321.

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Abstract

Neointimal hyperplasia (NIH) and impaired dilatation are important contributors to arteriovenous fistula (AVF) failure. It is unclear whether chronic kidney disease (CKD) itself causes adverse remodeling in arterialized veins. Here we determined if CKD specifically triggers adverse effects on vascular remodeling and assessed whether these changes affect the function of AVFs. For this purpose, we used rats on a normal diet or on an adenine-rich diet to induce CKD and created a fistula between the right femoral artery and vein. Fistula maturation was followed noninvasively by high-resolution ultrasound (US), and groups of rats were killed on 42 and 84 days after surgery for histological and immunohistochemical analyses of the AVFs and contralateral femoral vessels. In vivo US and ex vivo morphometric analyses confirmed a significant increase in NIH in the AVFs of both groups with CKD compared to those receiving a normal diet. Furthermore, we found using histological evaluation of the fistula veins in the rats with CKD that the media shrank and their calcification increased significantly. Afferent artery dilatation was significantly impaired in CKD and the downstream fistula vein had delayed dilation after surgery. These changes were accompanied by significantly increased peak systolic velocity at the site of the anastomosis, implying stenosis. Thus, CKD triggers adverse effects on vascular remodeling in AVFs, all of which contribute to anatomical and/or functional stenosis.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine > Department of Clinical and Experimental Medicine
Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Faculty of Health and Medical Sciences
Authors :
NameEmailORCID
Langer, Stephan
Kokozidou, Maria
Heiss, Christianc.heiss@surrey.ac.uk
Kranz, Jennifer
Kessler, Tina
Paulus, Niklas
Krüger, Thilo
Jacobs, Michael J.
Lente, Christina
Koeppel, Thomas A.
Date : 29 September 2010
Identification Number : 10.1038/ki.2010.353
Copyright Disclaimer : & 2010 International Society of Nephrology
Uncontrolled Keywords : Arteriovenous fistula; Arteriovenous shunt; Chronic kidney disease; Dialysis access; Vascular access
Depositing User : Diane Maxfield
Date Deposited : 14 Aug 2018 16:12
Last Modified : 14 Aug 2018 16:12
URI: http://epubs.surrey.ac.uk/id/eprint/848939

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