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Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Online ISSN 1827-1758
Diskin C. J.
Departments of Hypertention, Nephrology, Dialysis and Transplantion, Auburn University, Opelika, AL, USA
Greater insight into vascular pathophysiology and intimal hyperplasia has resulted in observational studies that suggest that interventions which decrease inflammatory mediators, improve endothelial function and inhibit smooth muscle migration and proliferation may be of benefit in improving hemodialysis vascular access survival. Longer dialysis times may also reduce inflammatory mediators and restore vascular sensitivity to endothelium dependent relaxation factor. In contrast, the common procedure of angioplasty is the experimental model to develop intimal hyperplasia and stenosis, while the efficacy of stents to prevent that stenosis in hemodialysis accesses remains controversial. Common drugs that interfere with metalloproteinases may prevent aneurysm formation while avoiding drugs that aid quorum sensing and using drugs that interfere with it may prevent biofilm infection in hemodialysis vascular catheters. Large prospective randomized studies will be needed to determine the true benefit.