The Role of Cardio-Renal Inflammation in Deciding the Fate of the Arteriovenous Fistula in Haemodialysis Therapy

Vascular access is an indispensable component of haemodialysis therapy for end-stage kidney disease patients. The arteriovenous fistula (AVF) is most common, but importantly, two-year failure rates are greater than fifty percent. AVF failure can occur due to a lack of suitable vascular remodelling,...

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Vydáno v:	Cells (Basel, Switzerland) Ročník 13; číslo 19; s. 1637
Hlavní autoři:	Kane, Jamie, Lemieux, Alaura, Baranwal, Gaurav, Misra, Sanjay
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Switzerland MDPI AG 01.10.2024 MDPI
Témata:	Animals Arteriovenous Fistula - pathology Arteriovenous Fistula - therapy arteriovenous fistulas Arteriovenous Shunt, Surgical - adverse effects Cell activation Cell proliferation Chemokines Chronic kidney failure End-stage renal disease Endothelial cells Endothelium Extravasation Fistula Fistula, Arteriovenous Fistulae Health aspects Hemodialysis Humans Hyperplasia Inflammation Inflammation - pathology Kidney - pathology Kidney diseases Kidney Failure, Chronic - pathology Kidney Failure, Chronic - therapy Mesenchymal stem cells Microenvironments Nitric oxide Paricalcitol Peritoneal dialysis Permeability Renal Dialysis - adverse effects Review Shear stress Smooth muscle Stem cells Stenosis Thrombosis Transplantation vascular smooth muscle cells Venous access United States > US inflammation vascular smooth muscle cells arteriovenous fistulas
ISSN:	2073-4409, 2073-4409
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Shrnutí:	Vascular access is an indispensable component of haemodialysis therapy for end-stage kidney disease patients. The arteriovenous fistula (AVF) is most common, but importantly, two-year failure rates are greater than fifty percent. AVF failure can occur due to a lack of suitable vascular remodelling, and inappropriate inflammation preventing maturation, or alternatively neointimal hyperplasia and vascular stenosis preventing long-term use. A comprehensive mechanistic understanding of these processes is still lacking, but recent studies highlight an essential role for inflammation from uraemia and the AVF itself. Inflammation affects each cell in the cascade of AVF failure, the endothelium, the infiltrating immune cells, and the vascular smooth muscle cells. This review examines the role of inflammation in each cell step by step and the influence on AVF failure. Inflammation resulting in AVF failure occurs initially via changes in endothelial cell activation, permeability, and vasoprotective chemokine secretion. Resultingly, immune cells can extravasate into the subendothelial space to release inflammatory cytokines and cause other deleterious changes to the microenvironment. Finally, all these changes modify vascular smooth muscle cell function, resulting in excessive and unchecked hyperplasia and proliferation, eventually leading to stenosis and the failure of the AVF. Finally, the emerging therapeutic options based off these findings are discussed, including mesenchymal stem cells, small-molecule inhibitors, and far-infrared therapies. Recent years have clearly demonstrated a vital role for inflammation in deciding the fate of the AVF, and future works must be centred on this to develop therapies for a hitherto unacceptably underserved patient population.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	2073-4409 2073-4409
DOI:	10.3390/cells13191637