PMID- 19080177
OWN - NLM
STAT- MEDLINE
DCOM- 20090106
LR  - 20220318
IS  - 0366-6999 (Print)
IS  - 0366-6999 (Linking)
VI  - 121
IP  - 21
DP  - 2008 Nov 5
TI  - Microinflammation is involved in the dysfunction of arteriovenous fistula in 
      patients with maintenance hemodialysis.
PG  - 2157-61
AB  - BACKGROUND: Vascular access (VA) dysfunction is a major clinical complication in 
      the hemodialysis population and has a direct effect on dialysis outcome. This 
      study was conducted to explore the role of microinflammation in the VA 
      dysfunction in maintenance hemodialysis patients. METHODS: Forty-seven patients 
      (male 35 and female 12) receiving maintenance hemodialysis were included for this 
      study. They were divided into three groups: group 1 (n = 15), patients with 
      initial hemodialysis and new arteriovenous fistula (AVF); group 2 (n = 18), 
      patients treated with hemodialysis for long term with well-functional VA; group 3 
      (n = 14), maintenance hemodialysis patients with VA dysfunction. Biochemical 
      parameters and serum tumor necrosis factor-alpha (TNF-alpha), interleukin 6 
      (IL-6) and monocyte chemoattractant protein-1 (MCP-1) were determined. 
      High-sensitivity C-reactive protein (hs-CRP) was determined by latex-enhanced 
      immuno-nephelometric method. Tissues of radial artery were taken from group 1 and 
      group 3 for the histological study. Expression of CD68 and MCP-1 in the radial 
      artery was determined by immunohistochemistry. RESULTS: Serum hs-CRP in group 3 
      was significantly higher than those in group 1 and group 2 ((7.40 +/- 2.42) mg/L 
      vs (4.21 +/- 1.62) mg/L and (5.04 +/- 3.65) mg/L, P < 0.01 and P < 0.05, 
      respectively). Serum TNF-alpha in group 3 was significantly higher than those in 
      group 1 and group 2 ((64.03 +/- 9.29) pg/ml vs (54.69 +/- 12.39) pg/ml and (54.05 
      +/- 7.68) pg/ml, P < 0.05 and P < 0.01, respectively). Serum IL-6 in group 3 was 
      also significantly higher than those in group 1 and group 2 ((70.09 +/- 14.53) 
      pg/ml vs (56.43 +/- 10.11) pg/ml and (60.77 +/- 9.70) pg/ml, P < 0.01 and P < 
      0.05, respectively). Patients in group 3 had a thicker internal layer of vessels 
      than in group 1 ((0.356 +/- 0.056) mm vs (0.111 +/- 0.021) mm, P < 0.01). 
      Expression of CD68 and MCP-1 in the fistula vessel walls in group 3 were much 
      higher than those in group 1 (P < 0.01). Moreover, serum hs-CRP level was 
      positively correlated with the neointimal hyperplasia, the expression of CD68 and 
      MCP-1 in fistula vessel (P < 0.01, respectively). CONCLUSION: Microinflammation 
      might be involved in the dysfunction of AVF in patients with maintenance 
      hemodialysis.
FAU - Liu, Bi-cheng
AU  - Liu BC
AD  - Institute of Nephrology, Zhong Da Hospital, Southeast University, Nanjing, 
      Jiangsu 210009, China. liubc64@yahoo.com.cn
FAU - Li, Li
AU  - Li L
FAU - Gao, Min
AU  - Gao M
FAU - Wang, Yan-li
AU  - Wang YL
FAU - Yu, Ji-rong
AU  - Yu JR
LA  - eng
PT  - Journal Article
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
RN  - 0 (Interleukin-6)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arteriovenous Shunt, Surgical/*adverse effects
MH  - C-Reactive Protein/analysis
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Inflammation/*etiology
MH  - Interleukin-6/blood
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/*adverse effects
EDAT- 2008/12/17 09:00
MHDA- 2009/01/07 09:00
CRDT- 2008/12/17 09:00
PHST- 2008/12/17 09:00 [entrez]
PHST- 2008/12/17 09:00 [pubmed]
PHST- 2009/01/07 09:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2008 Nov 5;121(21):2157-61.