The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Pre-existing arterial pathologic changes affecting arteriovenous fistula patency and cardiovascular mortality in hemodialysis patients

  • Lee, Ja Young (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Young Ok (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2017.08.02
  • Accepted : 2017.08.06
  • Published : 2017.09.01
⟨ Previous Next ⟩

Abstract

The radiocephalic arteriovenous fistula (AVF) provides optimal vascular access for hemodialysis; it has a higher long-term patency rate and fewer complications than other vascular access methods. However, the AVF has a high primary failure rate. The presence of small-diameter vessels at anastomosis sites is an important risk factor for AVF failure. However, in a recent study, despite selecting an adequate artery and vein for creating an AVF by routine preoperative vascular mapping, AVF maturation and primary failure occurred. Thus, pre-existing arteriosclerosis at AVF anastomosis sites likely contributes to AVF failure. In this review, we discuss the relationship between pathologic changes and AVF patency in hemodialysis patients. Because arteriosclerosis of the major arteries such as the coronary and carotid arteries is associated with cardiovascular mortality, we also review the impact of arteriosclerosis of upper arm arteries at AVF anastomosis sites on cardiovascular mortality in hemodialysis patients.

Keywords

References

  1. III. NKF-K/DOQI clinical practice guidelines for vascular access: update 2000. Am J Kidney Dis 2001;37(1 Suppl 1):S137-S181. https://doi.org/10.1016/S0272-6386(01)70007-8
  2. Lee J, Kim YS, Yoon SA, et al. Retrospective review of angiography before cannulation of newly created vascular accesses in hemodialysis patients. J Vasc Interv Radiol 2013;24:1309-1315. https://doi.org/10.1016/j.jvir.2013.04.035
  3. Lok CE. Fistula first initiative: advantages and pitfalls. Clin J Am Soc Nephrol 2007;2:1043-1053. https://doi.org/10.2215/CJN.01080307
  4. Patel ST, Hughes J, Mills JL Sr. Failure of arteriovenous fistula maturation: an unintended consequence of exceeding dialysis outcome quality Initiative guidelines for hemodialysis access. J Vasc Surg 2003;38:439-445. https://doi.org/10.1016/S0741-5214(03)00732-8
  5. Lok CE, Sontrop JM, Tomlinson G, et al. Cumulative patency of contemporary fistulas versus grafts (2000-2010). Clin J Am Soc Nephrol 2013;8:810-818. https://doi.org/10.2215/CJN.00730112
  6. Combe C, Berard X. Dialysis: 'catheter last' not 'fistula first' in elderly patients. Nat Rev Nephrol 2013;9:632-634. https://doi.org/10.1038/nrneph.2013.175
  7. DeSilva RN, Patibandla BK, Vin Y, et al. Fistula first is not always the best strategy for the elderly. J Am Soc Nephrol 2013;24:1297-1304. https://doi.org/10.1681/ASN.2012060632
  8. Peterson WJ, Barker J, Allon M. Disparities in fistula maturation persist despite preoperative vascular mapping. Clin J Am Soc Nephrol 2008;3:437-441. https://doi.org/10.2215/CJN.03480807
  9. Chitalia N, Ross L, Krishnamoorthy M, et al. Neointimal hyperplasia and calcification in medium sized arteries in adult patients with chronic kidney disease. Semin Dial 2015;28:E35-E40. https://doi.org/10.1111/sdi.12335
  10. Di Lullo L, House A, Gorini A, Santoboni A, Russo D, Ronco C. Chronic kidney disease and cardiovascular complications. Heart Fail Rev 2015;20:259-272. https://doi.org/10.1007/s10741-014-9460-9
  11. Schiffrin EL, Lipman ML, Mann JF. Chronic kidney disease: effects on the cardiovascular system. Circulation 2007;116:85-97. https://doi.org/10.1161/CIRCULATIONAHA.106.678342
  12. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32(5 Suppl 3):S112-S119. https://doi.org/10.1053/ajkd.1998.v32.pm9820470
  13. Sarnak MJ. Cardiovascular complications in chronic kidney disease. Am J Kidney Dis 2003;41(5 Suppl):11-17. https://doi.org/10.1016/S0272-6386(03)00372-X
  14. London GM, Marchais SJ, Guerin AP, Metivier F, Adda H. Arterial structure and function in end-stage renal disease. Nephrol Dial Transplant 2002;17:1713-1724. https://doi.org/10.1093/ndt/17.10.1713
  15. Klassen PS, Lowrie EG, Reddan DN, et al. Association between pulse pressure and mortality in patients undergoing maintenance hemodialysis. JAMA 2002;287:1548-1555. https://doi.org/10.1001/jama.287.12.1548
  16. Ejerblad S, Ericsson JL, Eriksson I. Arterial lesions of the radial artery in uraemic patients. Acta Chir Scand 1979;145:415-428.
  17. Ruengsakulrach P, Sinclair R, Komeda M, Raman J, Gordon I, Buxton B. Comparative histopathology of radial artery versus internal thoracic artery and risk factors for development of intimal hyperplasia and atherosclerosis. Circulation 1999;100:II139-II144.
  18. MacKay AJ, Hamilton CA, McArthur K, et al. Radial artery hypertrophy occurs in coronary atherosclerosis and is independent of blood pressure. Clin Sci (Lond) 2001;100:509-516. https://doi.org/10.1042/cs1000509
  19. Chowdhury UK, Airan B, Mishra PK, et al. Histopathology and morphometry of radial artery conduits: basic study and clinical application. Ann Thorac Surg 2004;78:1614-1621. https://doi.org/10.1016/j.athoracsur.2004.03.105
  20. Johansson M, Myredal A, Friberg P, Gan LM. High-resolution ultrasound showing increased intima and media thickness of the radial artery in patients with end-stage renal disease. Atherosclerosis 2010;211:159-163. https://doi.org/10.1016/j.atherosclerosis.2010.01.031
  21. Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 1995;92:1355-1374. https://doi.org/10.1161/01.CIR.92.5.1355
  22. Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993;362:801-809. https://doi.org/10.1038/362801a0
  23. Kim YO, Song HC, Yoon SA, et al. Preexisting intimal hyperplasia of radial artery is associated with early failure of radiocephalic arteriovenous fistula in hemodialysis patients. Am J Kidney Dis 2003;41:422-428. https://doi.org/10.1053/ajkd.2003.50051
  24. Sato M, Ogawa T, Sugimoto H, Otsuka K, Nitta K. Relation of carotid intima-media thickness and silent cerebral infarction to cardiovascular events and all-cause mortality in chronic hemodialysis patients. Intern Med 2012;51:2111-2117. https://doi.org/10.2169/internalmedicine.51.8044
  25. Szeto CC, Chow KM, Woo KS, et al. Carotid intima media thickness predicts cardiovascular diseases in Chinese predialysis patients with chronic kidney disease. J Am Soc Nephrol 2007;18:1966-1972. https://doi.org/10.1681/ASN.2006101184
  26. Nishizawa Y, Shoji T, Maekawa K, et al. Intima-media thickness of carotid artery predicts cardiovascular mortality in hemodialysis patients. Am J Kidney Dis 2003;41(3 Suppl 1):S76-S79. https://doi.org/10.1053/ajkd.2003.50090
  27. Amann K. Media calcification and intima calcification are distinct entities in chronic kidney disease. Clin J Am Soc Nephrol 2008;3:1599-1605. https://doi.org/10.2215/CJN.02120508
  28. Himmelfarb J, Saad T. Hemodialysis vascular access: emerging concepts. Curr Opin Nephrol Hypertens 1996;5:485-491. https://doi.org/10.1097/00041552-199611000-00005
  29. Mousa AY, Dearing DD, Aburahma AF. Radiocephalic fistula: review and update. Ann Vasc Surg 2013;27:370-378. https://doi.org/10.1016/j.avsg.2012.07.012
  30. Browne LD, Bashar K, Griffin P, Kavanagh EG, Walsh SR, Walsh MT. The role of shear stress in arteriovenous fistula maturation and failure: a systematic review. PLoS One 2015;10:e0145795. https://doi.org/10.1371/journal.pone.0145795
  31. Sivanesan S, How TV, Bakran A. Characterizing flow distributions in AV fistulae for haemodialysis access. Nephrol Dial Transplant 1998;13:3108-3110. https://doi.org/10.1093/ndt/13.12.3108
  32. Ene-Iordache B, Mosconi L, Antiga L, et al. Radial artery remodeling in response to shear stress increase within arteriovenous fistula for hemodialysis access. Endothelium 2003;10:95-102. https://doi.org/10.1080/10623320303365
  33. Kim YO, Choi YJ, Kim JI, et al. The impact of intima-media thickness of radial artery on early failure of radiocephalic arteriovenous fistula in hemodialysis patients. J Korean Med Sci 2006;21:284-289. https://doi.org/10.3346/jkms.2006.21.2.284
  34. Allon M, Litovsky S, Young CJ, et al. Medial fibrosis, vascular calcification, intimal hyperplasia, and arteriovenous fistula maturation. Am J Kidney Dis 2011;58:437-443. https://doi.org/10.1053/j.ajkd.2011.04.018
  35. Yan TK, Lin S, Jia JY, Li YP, Shang WY, Wei L. The histological changes in radial artery in uremia and their effects on arterial stiffness. Zhonghua Nei Ke Za Zhi 2010;49:577-581.
  36. Allon M, Litovsky S, Young CJ, et al. Correlation of pre-existing vascular pathology with arteriovenous graft outcomes in hemodialysis patients. Am J Kidney Dis 2013;62:1122-1129. https://doi.org/10.1053/j.ajkd.2013.03.040
  37. Kaufer E, Factor SM, Frame R, Brodman RF. Pathology of the radial and internal thoracic arteries used as coronary artery bypass grafts. Ann Thorac Surg 1997;63:1118-1122. https://doi.org/10.1016/S0003-4975(96)01393-8
  38. Tripathi V, Bansal S, Alok S, Ravi B, Devra AK, Saxena S. Histopathological changes of radial artery wall in patients of chronic kidney disease stage 5 undergoing AV fistula formation and their correlation with serum iPTH levels. Saudi J Kidney Dis Transpl 2015;26:884-889. https://doi.org/10.4103/1319-2442.164562
  39. Ku YM, Kim YO, Kim JI, et al. Ultrasonographic measurement of intima-media thickness of radial artery in pre-dialysis uraemic patients: comparison with histological examination. Nephrol Dial Transplant 2006;21:715-720. https://doi.org/10.1093/ndt/gfi214
  40. Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J. Intima-media thickness: a new tool for diagnosis and treatment of cardiovascular risk. J Hypertens 2002;20:159-169. https://doi.org/10.1097/00004872-200202000-00001
  41. Mizobuchi M, Towler D, Slatopolsky E. Vascular calcification: the killer of patients with chronic kidney disease. J Am Soc Nephrol 2009;20:1453-1464. https://doi.org/10.1681/ASN.2008070692
  42. Paloian NJ, Giachelli CM. A current understanding of vascular calcification in CKD. Am J Physiol Renal Physiol 2014;307:F891-F900. https://doi.org/10.1152/ajprenal.00163.2014
  43. Yun YS, Yun SS, Kim HK, Kim YO. The histopathologic analysis of microcalcification of the radial artery in patients with end stage renal disease [abstract]. J Vasc Access 2011;12:173.
  44. Shroff RC, McNair R, Figg N, et al. Dialysis accelerates medial vascular calcification in part by triggering smooth muscle cell apoptosis. Circulation 2008;118:1748-1757. https://doi.org/10.1161/CIRCULATIONAHA.108.783738
  45. Kim HG, Park SC, Lee SL, et al. Arterial micro-calcification of vascular access is associated with aortic arch calcification and arterial stiffness in hemodialysis patients. Semin Dial 2013;26:216-222. https://doi.org/10.1111/j.1525-139X.2012.01113.x
  46. Yun YS, Choi SJ, Lee JY, et al. Impact of arterial microcalcification of the vascular access on cardiovascular mortality in hemodialysis patients. Hemodial Int 2014;18:54-61. https://doi.org/10.1111/hdi.12074
  47. Choi SJ, Yoon HE, Kim YS, et al. Pre-existing arterial micro-calcification predicts primary unassisted arteriovenous fistula failure in incident hemodialysis patients. Semin Dial 2015;28:665-669. https://doi.org/10.1111/sdi.12365
  48. Allon M, Robbin ML, Umphrey HR, et al. Preoperative arterial microcalcification and clinical outcomes of arteriovenous fistulas for hemodialysis. Am J Kidney Dis 2015;66:84-90. https://doi.org/10.1053/j.ajkd.2014.12.015
  49. Wang N, Yang J, Yu X, et al. Radial artery calcification in end-stage renal disease patients is associated with deposition of osteopontin and diminished expression of alpha-smooth muscle actin. Nephrology (Carlton) 2008;13:367-375. https://doi.org/10.1111/j.1440-1797.2008.00941.x
  50. Georgiadis GS, Georgakarakos EI, Antoniou GA, et al. Correlation of pre-existing radial artery macrocalcifications with late patency of primary radiocephalic fistulas in diabetic hemodialysis patients. J Vasc Surg 2014;60:462-470. https://doi.org/10.1016/j.jvs.2014.02.042
  51. Kim MK, Kim B, Lee JY, et al. Tissue Doppler-derived E/e' ratio as a parameter for assessing diastolic heart failure and as a predictor of mortality in patients with chronic kidney disease. Korean J Intern Med 2013;28:35-44. https://doi.org/10.3904/kjim.2013.28.1.35
  52. Di Vito L, Porto I, Burzotta F, et al. Radial artery intima-media ratio predicts presence of coronary thin-cap fibroatheroma: a frequency domain-optical coherence tomography study. Int J Cardiol 2013;168:1917-1922. https://doi.org/10.1016/j.ijcard.2012.12.082
  53. London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003;18:1731-1740. https://doi.org/10.1093/ndt/gfg414
  54. Janda K, Krzanowski M, Gajda M, et al. Cardiovascular risk in chronic kidney disease patients: intima-media thickness predicts the incidence and severity of histologically assessed medial calcification in radial arteries. BMC Nephrol 2015;16:78. https://doi.org/10.1186/s12882-015-0067-8

Cited by

  1. LONG-TERM PATENCY RATE OF AV-FISTULA IN RELATION TO DIAMETER OF ARTERIOTOMY 3 MM VS <3 MM vol.7, pp.52, 2017, https://doi.org/10.14260/jemds/2018/1226
  2. Supplementary nutrients for prevention of vascular calcification in patients with chronic kidney disease vol.34, pp.3, 2017, https://doi.org/10.3904/kjim.2019.125
  3. The Impact of Comorbidity Burden on The Association between Vascular Access Type and Clinical Outcomes among Elderly Patients Undergoing Hemodialysis vol.9, pp.1, 2019, https://doi.org/10.1038/s41598-019-54191-1
  4. The Effect of Different Factorson the Initial Dysfunction of Forearm Arteriovenous Fistula in Uremia Patients vol.10, pp.4, 2017, https://doi.org/10.12677/acm.2020.104082
  5. The Predictive Factors of Arteriovenous Fistula Maturation in Patients with End-Stage Renal Disease vol.25, pp.1, 2017, https://doi.org/10.2309/j.java.2020.001.002
  6. Computer assisted Doppler waveform analysis and ultrasound derived turbulence intensity ratios can predict early hyperplasia development in newly created vascular access fistula: Pilot study, methodol vol.10, pp.None, 2017, https://doi.org/10.1177/20480040211000185
  7. Integrated management to reduce fistula‐related long‐term complications and improve the quality of life after arteriovenous fistula surgery: A retrospective cohort study vol.8, pp.4, 2017, https://doi.org/10.1002/nop2.839
  8. Association of early failure of arteriovenous fistula with mortality in hemodialysis patients vol.11, pp.1, 2017, https://doi.org/10.1038/s41598-021-85267-6