Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients

Cheung, Alfred K.; Sarnak, Mark J.; Gao, Yan; Dwyer, Johanna T.; Heyka, Robert; Rocco, Michael V.; Teehan, Brendan P.; Levey, Andrew S.

doi:10.1046/j.1523-1755.2000.00173.x

Cited by 701 publications

(501 citation statements)

References 23 publications

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“…It is known that the uremic milieu in patients with end stage renal disease contributes to a multitude of vascular diseases including venous intimal hyperplasia even prior to hemodialysis access surgery [14][15][16] . This present model does not incorporate the uremic milieu.…”

Section: Representative Resultsmentioning

confidence: 99%

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

Wong

Vries

Wang

et al. 2016

JoVE

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The arteriovenous fistula (AVF) still suffers from a high number of failures caused by insufficient remodeling and intimal hyperplasia from which the exact pathophysiology remains unknown. In order to unravel the pathophysiology a murine model of AVF-failure was developed in which the configuration of the anastomosis resembles the preferred situation in the clinical setting. A model was described in which an AVF is created by connecting the venous end of the branch of the external jugular vein to the side of the common carotid artery using interrupted sutures. At a histological level, we observed progressive stenotic intimal lesions in the venous outflow tract that is also seen in failed human AVFs. Although this procedure can be technically challenging due to the small dimensions of the animal, we were able to achieve a surgical success rate of 97% after sufficient training. The key advantage of a murine model is the availability of transgenic animals. In view of the different proposed mechanisms that are responsible for AVF failure, disabling genes that might play a role in vascular remodeling can help us to unravel the complex pathophysiology of AVF failure. Video LinkThe video component of this article can be found at

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Section: Representative Resultsmentioning

confidence: 99%

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

Wong

Vries

Wang

et al. 2016

JoVE

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“…51 Patients with ESRD have a greatly increased risk of CVD throughout the vascular tree. For instance, in the National Institutes of Health hemodialysis study, 52 prevalence of cerebrovascular disease, PAD, and CHD was 19%, 23%, and 40%, respectively. The diffuse atherosclerosis contributes to the continuum of increased cardiovascular mortality with increasingly severe renal disease.…”

Section: Renal Atherosclerotic Vascular Diseasementioning

confidence: 99%

Atherosclerotic Vascular Disease Conference

Pasternak¹,

Criqui²,

Benjamin³

et al. 2004

Circulation

170

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“…The origin of cardiovascular disease is multifactorial; factors such as retention of uremic toxins, microinflammation, atherosclerosis, a fluctuating extracellular fluid volume, and hypertension have been implicated (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial of Hemodiafiltration and Change in Cardiovascular Parameters

Mostovaya¹,

Bots

Dorpel

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objective Increased left ventricular mass (LVM), low ventricular ejection fraction (EF), and high pulse-wave velocity (PWV) relate to overall and cardiovascular mortality in patients with ESRD. The aim of this study was to determine the effect of online hemodiafiltration (HDF) versus low-flux hemodialysis (HD) on LVM, EF, and PWV.Design, setting, participants, & measurements Echocardiography was used to assess LVM and EF in 342 patients in the CONvective TRAnsport STudy followed for up to 4 years. PWV was measured in 189 patients for up to 3 years. Effect of HDF versus HD on LVM, EF, and PWV was evaluated using linear mixed models.Results Patients had a mean age of 63 years, and 61% were male. At baseline, median LVM was 227 g (interquartile range [IQR], 183-279 g), and median EF was 65% (IQR, 55%-72%). Median PWV was 9.8 m/s (IQR, 7.5-12.0 m/s). There was no significant difference between the HDF and HD treatment groups in rate of change in LVM (HDF: change, 20.9 g/yr [95% confidence interval (95% CI), 28.9 to 7.7 g]; HD: change, 12.5 g/yr [95% CI, 23.0 to 27.5 g]; P for difference=0. Conclusions Treatment with online HDF did not affect changes in LVM, EF, or PWV over time compared with HD.

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Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients

Cited by 701 publications

References 23 publications

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

Atherosclerotic Vascular Disease Conference

A Randomized Trial of Hemodiafiltration and Change in Cardiovascular Parameters

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