Vascular access in hemodialysis: issues, management, and emerging concepts

Cardiol Clin. 2005 Aug;23(3):249-73. doi: 10.1016/j.ccl.2005.04.004.


This article (1) identifies the types of hemodialysis access, (2) summarizes the clinical standard of care for dialysis access grafts and fistulae, (3) describes the pathology and pathogenesis of venous stenosis in dialysis access grafts and fistulae, (4) tabulates avail-able therapies for hemodialysis vascular access dysfunction and speculates on the rea-sons for the lack of effective therapies, and (5) discusses the development and application of novel therapeutic interventions for this difficult clinical problem. The possibility that dialysis access grafts and fistulae could be the ideal clinical model for testing novel local therapies to block neointimal hyperplasia is discussed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Arteriovenous Anastomosis*
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Arteriovenous Shunt, Surgical / methods
  • Blood Vessel Prosthesis
  • Catheters, Indwelling / adverse effects*
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / pathology
  • Constriction, Pathologic / therapy
  • Humans
  • Kidney Failure, Chronic / therapy
  • Peripheral Vascular Diseases / etiology*
  • Peripheral Vascular Diseases / pathology
  • Peripheral Vascular Diseases / therapy*
  • Polytetrafluoroethylene
  • Prohibitins
  • Renal Dialysis*


  • PHB2 protein, human
  • Prohibitins
  • Polytetrafluoroethylene