Severe Endothelial Damage in Chronic Kidney Disease Patients Prior to Haemodialysis Vascular Access Surgery

Vladimir Pushevski; Petar Dejanov; Vesna Gerasimovska; Gordana Petrushevska; Angel Oncevski; Aleksandar Sikole; Zivko Popov; Ninoslav Ivanovski

doi:10.1515/prilozi-2015-0077

Severe Endothelial Damage in Chronic Kidney Disease Patients Prior to Haemodialysis Vascular Access Surgery

Journal

Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)

Date Issued

2015

Author(s)

Angel Oncevski

Zivko Popov

Ninoslav Ivanovski

DOI

10.1515/prilozi-2015-0077

Abstract

Hemodialysis as an efficient therapy for advanced CKD is the most used treatment modality all over the world. Even though primary AVF is widely accepted as a best permanent vascular access in hemodialysis patients, up to 60% of all fistulas fail to mature. The pathogenesis of early fistula failure is not very well understood. Many general and local factors are involved: patient's age, sex, primary renal disease, small vessel's diameter, presence of accessory veins, prior venipunctures, surgical skill, genetics, etc. Histological investigations have confirmed the neointimal venous hyperplasia as a major pathological finding in stenotic lesions of AVF failure, due to local inflammation, oxidative stress and migration and proliferation of myofibroblasts, fibroblasts and endothelial cells.