Document Detail


Pathogenesis and local drug delivery for prevention of vascular access stenosis.
MedLine Citation:
PMID:  18089461     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A well-functioning vascular access is essential for hemodialysis in end-stage kidney disease patients. Synthetic grafts are more prone to the development of stenosis than native fistulas. Most of the stenosis is caused by neointimal hyperplasia localized at the outflow tract, which is perpetuated by continuous stimuli, such as blood flow disturbance, graft material bioincompatibility, and repeated needle puncture. Hyperplasia formation is also enhanced by the trauma of angioplasty. Recent work suggests that angiogenesis and the migration and proliferation of fibroblasts in the adventitia are important for the pathogenesis of neointimal hyperplasia. Therefore, the perivascular sustained delivery of antiproliferative drugs is a rational approach to inhibit hyperplasia associated with hemodialysis grafts. Because of the chronic nature of the stimuli, strategies that allow for the ready replenishment of the drug depot are preferable and are currently under development.
Authors:
Alfred K Cheung; Christi Terry; Li Li
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  18     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-03-07     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  140-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Arteriovenous Fistula / prevention & control*
Catheters, Indwelling / adverse effects*
Constriction, Pathologic / prevention & control*
Drug Therapy / methods*
Endothelium, Vascular / pathology
Humans
Tunica Intima / pathology
Grant Support
ID/Acronym/Agency:
R01 HL067646/HL/NHLBI NIH HHS; R01 HL067646-05/HL/NHLBI NIH HHS; R01-HL67646/HL/NHLBI NIH HHS
Comments/Corrections

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