Morphometric and histological parameters in veins of diabetic patients undergoing brachiocephalic fistula placement

Hemodialysis International
Ivana LazichMary S Hammes

Abstract

Diabetic patients with end-stage renal failure have higher rates of arteriovenous failures when compared with nondiabetics. The aim was to compare differences in indicators of vascular remodeling and endothelial dysfunction in veins of patients with or without diabetes at the time of surgical placement. In this prospective observational trial, vein samples were collected from patients when a brachiocephalic fistula was created. Morphometric measurements and extent of fibrosis were determined using Image J software. Histological analysis, for the presence of myofibroblasts and level of endothelial nitric oxide synthase, was performed by immunohistochemical staining and scored in semi-quantitative manner. Asymmetric dimethylarginine was determined at the time of access placement. Comparison of diabetics and nondiabetics was performed using Wilcoxon rank sum and Fisher's exact tests. Eighteen patients were included; 10 were diabetics. There was a significant difference in the measurement of vein area between groups, with diabetic vein samples having larger luminal area of average 832,001.18 μm(2) (317,582.17-3,695,670.36, P = 0.04). The maximal intimal to medial thickness ratio was higher in diabetic vein samples (0.71 vs. 0.24, P...Continue Reading

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Citations

Mar 9, 2019·Tissue Engineering. Part a·Khairunnisa RamliMin Hwei Ng
Jul 21, 2017·Journal of the American Society of Nephrology : JASN·Charles E AlpersUNKNOWN Hemodialysis Fistula Maturation Study Group
Sep 11, 2019·International Journal of Molecular Sciences·Gonzalo I GómezJuan C Sáez

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