METHODS: Eighty-nine stage 4-5 CKD patients underwent standard preoperative assessment, including the Doppler ultrasound, before a typical radio-cephalic AVF creation. Post-failure, a new AVF was created proximally. The vein specimens were collected during the surgery, processed, and analyzed for morphometric analyses and various cellular markers, including Vimentin, TGF, and Ki 67.
RESULTS: The study enrolled 89 CKD patients, analyzing various aspects of their condition and AVF failures. The histomorphometric analysis revealed substantial venous luminal stenosis and varied endothelial changes. The immunohistologic analysis showed differential marker expressions pre- and post-AVF creation.
CONCLUSIONS: This study highlights the complexity of the early AVF failures in CKD patients. The medial hypertrophy emerged as a significant preexisting lesion, while the postoperative analyses indicated a shift towards neointimal hyperplasia. The research underscores the nuanced interplay of vascular remodeling, endothelial damage, and cellular proliferation in the AVF outcomes.
方法:89例4-5期CKD患者接受标准术前评估,包括多普勒超声,在典型的射头AVF创建之前。失败后,在近端创建了一个新的AVF。手术期间采集静脉标本,已处理,并分析形态分析和各种细胞标记,包括Vimentin,TGF,Ki67
结果:该研究招募了89名CKD患者,分析其状况和AVF故障的各个方面。组织形态计量学分析显示静脉腔严重狭窄和内皮变化。免疫组织学分析显示了AVF产生前后的差异标记表达。
结论:本研究强调了CKD患者早期AVF衰竭的复杂性。内侧肥大表现为明显的预先存在的病变,而术后分析表明向新内膜增生转变。这项研究强调了血管重塑的微妙相互作用,内皮损伤,和AVF结果中的细胞增殖。