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BioMed Research International
Volume 2015, Article ID 171674, 7 pages
http://dx.doi.org/10.1155/2015/171674
Review Article

Hemodynamic and Biologic Determinates of Arteriovenous Fistula Outcomes in Renal Failure Patients

Department of Medicine, Nephrology Section, The University of Chicago, 5841 South Maryland Avenue, MC5100, Chicago, IL 60637, USA

Received 20 March 2015; Accepted 24 May 2015

Academic Editor: Umberto Benedetto

Copyright © 2015 Mary Hammes. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The outcome of patients with end-stage renal disease on hemodialysis depends on a functioning vascular access. Although a variety of access options are available, the arteriovenous fistula remains the best vascular access. Unfortunately the success rate of mature fistula use remains poor. The creation of an arteriovenous fistula is followed by altered hemodynamic and biological changes that may result in neointimal hyperplasia and eventual venous stenosis. This review provides an overview of these changes and the needed research to provide a long lasting vascular access and hence improve outcomes for patients with end-stage renal disease.