Saito Osamu, Kotouda Atushi, Saito Takako, Sugase Taro, Akimoto Tetsu, Ando Yasuhiro, Muto Shigeaki, Kusano Eiji
自治医科大学紀要 = Jichi Medical University Journal 35 1-6 2013年3月
Background： In hemodialysis patients, failure of arteriovenous fistula（ AVF） is a serious problem. AVFstenosis is dominant cause of vascular access failure. We hypothesized that vascular endothelial damage maybe involved in arteriovenous fistula（ AVF） stenosis.Methods： A cross-sectional observational survey was performed in 122 patients receiving maintenancehemodialysis in January - April 2004. Serum levels of adiponectin, adhesion molecules（ intercellular adhesionmolecule-1； ICAM-1 and vascular cell adhesion molecule-1； VCAM-1）, and endothelial injury markers（CD146 and thrombomodulin） were compared between 46 patients with AVF stenosis and 76 patientswithout AVF stenosis to determine factors associated with AVF stenosis.Results： The serum adiponectin level was significantly lower in patients with AVF stenosis compared tothose without AVF stenosis. Similarly, the serum levels of ICAM-1 and thrombomodulin were significantlylower in patients with AVF stenosis, whereas the serum level of VCAM-1 was significantly higher in patientswith AVF stenosis. There were no significant differences in other parameters between the two groups.Logistic regression analysis with the presence or absence of AVF stenosis as the dependent variable showedthat administration of an antihypertensive drug, VCAM-1, ICAM-1 and thrombomodulin were significantlyassociated with the presence of AVF stenosis in hemodialysis patients.Conclusion： The significant associations of administration of an antihypertensive drug, VCAM-1, ICAM-1 and thrombomodulin with AVF stenosis suggest that endothelial injury may play a critical role in thiscondition.
