Document Detail

Why don't fistulas mature?
MedLine Citation:
PMID:  16883317     Owner:  NLM     Status:  MEDLINE    
Fistula maturation requires a compliant and responsive vasculature capable of dilating in response to the increased velocity of blood flowing into the newly created low-resistance circuit. Successful maturation to a high volume flow circuit capable of sustaining hemodialysis typically occurs within the first few weeks after creation. Failure to achieve maturation within 4-8 weeks should prompt a search for reversible etiologies; however, an accepted definition of maturation, particularly for patients not yet on dialysis remains elusive. The most commonly identified etiology is neointimal hyperplasia typically occurring in the juxta-anastomotic vein. However, failed maturation has also been reported secondary to impaired arterial and venous dilation and accessory veins. The exact frequency of each of these etiologies is unclear. Understanding the etiologies of impaired fistula maturation will focus future studies of targeted interventions to improve the rate of fistula maturation and increase the number of dialysis patients with a functioning autogenous fistula.
B S Dixon
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2006-08-02
Journal Detail:
Title:  Kidney international     Volume:  70     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-06     Completed Date:  2006-11-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1413-22     Citation Subset:  IM    
Veterans Affairs Medical Center, Nephrology Division, University of Iowa School of Medicine, Iowa city, Iowa 52242-1081, USA.
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MeSH Terms
Arteriovenous Shunt, Surgical / methods*
Regional Blood Flow / physiology
Renal Dialysis / methods*
Time Factors
Vasodilation / physiology
Grant Support
Comment In:
Kidney Int. 2007 Sep;72(6):772   [PMID:  17805320 ]

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