Roy-Chaudhury Prabir, Lee Timmy C
Division of Nephrology and the Cincinnati Dialysis Access Research Program, University of Cincinnati, Cincinnati, Ohio 45267-0585, USA.
Curr Opin Nephrol Hypertens. 2007 Nov;16(6):516-22. doi: 10.1097/MNH.0b013e3282efa57f.
The aim of this review will be to summarize recent concepts pertaining to the pathophysiology of dialysis access stenosis and to then use this information to highlight novel interventions (both diagnostic and therapeutic) for dialysis access dysfunction. The studies covered in this review will include experimental and observational studies in addition to clinical trials.
An important biological focus of this review will be an emphasis on the role of the adventitia and progenitor cells in the pathogenesis of dialysis access dysfunction. The main interventional focus will be on access surveillance, local drug delivery and other novel therapeutic interventions. An important underlying theme throughout this review will be an emphasis on arteriovenous fistulae and on the many advantages of local therapeutic interventions in the specific clinical setting of dialysis access dysfunction.
Vascular access dysfunction remains a significant cause of morbidity and mortality for hemodialysis patients. We believe that a better understanding of the biological mechanisms of vascular access stenosis will help guide the development of novel therapies to prevent and treat dialysis access stenosis.
本综述旨在总结近期有关透析通路狭窄病理生理学的概念，然后利用这些信息突出针对透析通路功能障碍的新型干预措施（包括诊断和治疗）。本综述涵盖的研究将包括除临床试验外的实验性和观察性研究。
本综述的一个重要生物学重点将是强调外膜和祖细胞在透析通路功能障碍发病机制中的作用。主要干预重点将是通路监测、局部药物递送及其他新型治疗干预措施。贯穿本综述的一个重要潜在主题将是强调动静脉内瘘以及局部治疗干预措施在透析通路功能障碍特定临床环境中的诸多优势。
血管通路功能障碍仍然是血液透析患者发病和死亡的重要原因。我们认为，更好地理解血管通路狭窄的生物学机制将有助于指导开发预防和治疗透析通路狭窄的新型疗法。
