Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 17 (4), 1112-27

Hemodialysis Vascular Access Dysfunction: A Cellular and Molecular Viewpoint


Hemodialysis Vascular Access Dysfunction: A Cellular and Molecular Viewpoint

Prabir Roy-Chaudhury et al. J Am Soc Nephrol.


Hemodialysis vascular access dysfunction is a major cause of morbidity and hospitalization in the hemodialysis population. The major cause of hemodialysis vascular access dysfunction is venous stenosis as a result of neointimal hyperplasia. Despite the magnitude of the clinical problem, however, there has been a paucity of novel therapeutic interventions in this field. This is in marked contrast to a recent plethora of targeted interventions for the treatment of arterial neointimal hyperplasia after coronary angioplasty. The reasons for this are two-fold. First there has been a relative lack of cellular and molecular research that focuses on venous neointimal hyperplasia in the specific setting of hemodialysis vascular access. Second, there have been inadequate efforts by the nephrology community to translate the recent advances in molecular and interventional cardiology into therapies for hemodialysis vascular access. This review therefore (1) briefly examines the different forms of hemodialysis vascular access that are available, (2) describes the pathology and pathogenesis of hemodialysis vascular access dysfunction in both polytetrafluoroethylene grafts and native arteriovenous fistulae, (3) reviews recent concepts about the pathogenesis of vascular stenosis that could potentially be applied in the setting of hemodialysis vascular access dysfunction, (4) summarizes novel experimental and clinical therapies that could potentially be used in the setting of hemodialysis vascular access dysfunction, and, finally, (5) offers some broad guidelines for future innovative translational and clinical research in this area that hopefully will reduce the huge clinical morbidity and economic costs that are associated with this condition.

Similar articles

  • Vascular Access in Hemodialysis: Issues, Management, and Emerging Concepts
    P Roy-Chaudhury et al. Cardiol Clin 23 (3), 249-73. PMID 16084276. - Review
    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 path …
  • Novel Therapies for Hemodialysis Vascular Access Dysfunction: Fact or Fiction!
    P Roy-Chaudhury et al. Blood Purif 23 (1), 29-35. PMID 15627734. - Review
    Hemodialysis vascular access dysfunction is a major cause of morbidity in the hemodialysis population and contributes significantly to the overall cost of end-stage renal …
  • Vascular Stenosis: Biology and Interventions
    P Roy-Chaudhury et al. Curr Opin Nephrol Hypertens 16 (6), 516-22. PMID 18089964. - Review
    Vascular access dysfunction remains a significant cause of morbidity and mortality for hemodialysis patients. We believe that a better understanding of the biological mec …
  • Hemodialysis Vascular Access Dysfunction: Molecular Mechanisms and Treatment
    A Mima. Ther Apher Dial 16 (4), 321-7. PMID 22817119. - Review
    Hemodialysis vascular access complications are one of the main causes associated with an increase in morbidity and hospitalization in hemodialysis (HD) patients. The most …
  • Hemodialysis Vascular Access Morbidity
    HI Feldman et al. J Am Soc Nephrol 7 (4), 523-35. PMID 8724885. - Review
    Complications associated with hemodialysis vascular access represent one of the most important sources of morbidity among ESRD patients in the United States today. In thi …
See all similar articles

Cited by 119 PubMed Central articles

See all "Cited by" articles

Publication types


LinkOut - more resources