Abstract
Objective
The aim of the study was to evaluate the role of atherosclerosis risk factors and
baseline inflammatory status in the development of restenosis after successful percutaneous
transluminal angioplasty (PTA) of hemodialysis arteriovenous (AV) fistulas.
Research design and methods
We obtained baseline plasma biochemistry and inflammatory markers in 140 patients
with dysfunctional AV fistulas before the PTA procedures. Patients were followed clinically
for 6 months.
Results
There was no significant difference in the baseline inflammatory markers between the
restenosis and patency group. The Kaplan–Meier analysis showed that non-diabetic patients
had higher patency rate than diabetic patients (69% vs. 48%, p = 0.02) and diabetic patients with optimal glycemic control had higher patency rate
than patients with suboptimal glycemic control (61% vs. 30%, p = 0.01).
Conclusions
The presence of diabetes mellitus predicted restenosis of AV fistulas after PTA and
optimal blood glucose control might be critical to the patency after PTA.
Keywords
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References
- Hemodialysis access failure: a call to action.Kidney Int. 1998; 54: 1029-1040
- Vascular access in hemodialysis: issues, management, and emerging concepts.Cardiol Clin. 2005; 23: 249-273
- Outcome and prognostic factors of restenosis after percutaneous treatment of native hemodialysis fistulas.J Vasc Interv Radiol. 2002; 13: 51-59
- Dysfunctional autogenous hemodialysis fistulas: outcomes after angioplasty—are there clinical predictors of patency?.Radiology. 2004; 232: 508-515
- Plasma ADMA predicts restenosis of arteriovenous fistula.J Am Soc Nephrol. 2009; 20: 213-222
- Transforming growth factor beta1 genotype polymorphisms determine AV fistula patency in hemodialysis patients.Kidney Int. 2003; 64: 1101-1107
- Standards of medical care in diabetes—2008.Diabetes Care. 2008; 31: S12-S54
- Potential mechanisms promoting restenosis in diabetic patients.J Am Coll Cardiol. 1996; 27: 528-535
- High glucose impairs early and late endothelial progenitor cells by modifying nitric oxide-related but not oxidative stress-mediated mechanisms.Diabetes. 2007; 56: 1559-1568
- The microinflammatory state in uremia: causes and potential consequences.J Am Soc Nephrol. 2001; 12: 1549-1557
- Direct evidence for cytokine involvement in neointimal hyperplasia.Circulation. 2000; 102: 1697-1702
- Risk factors for vascular disease and arteriovenous fistula dysfunction in hemodialysis patients.J Am Soc Nephrol. 1996; 7: 1169-1177
- Thrombosed arteriovenous fistula for hemodialysis access is characterized by a marked inflammatory activity.Kidney Int. 2005; 68: 1312-1319
- Local activation of interleukin 6 signaling is associated with arteriovenous fistula stenosis in hemodialysis patients.Am J Kidney Dis. 2007; 49: 664-673
- Hemodialysis vascular access survival: upper-arm native arteriovenous fistula.Am J Kidney Dis. 2002; 39: 92-101
Article Info
Publication History
Published online: November 26, 2009
Accepted:
October 9,
2009
Received:
October 7,
2009
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
