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Friday, April 23, 2010

TOPIC DISCUSSION: Why do AVG and AVF get stenosis?

What I learned at the NKF.. about this.

1. Veins are not arteries and they are more prone to endothelial dysfunction
2. ESRD is a state of worsening endothelial dysfunction
3. ESRD and graft formation leads to neointimal hyperplasia and less NO production leading to endothelial damage
4. Most of these grafts and fistulas have a flow pattern that is more " turbulent rather than laminar" causing more sheer stress leading to endothelial dysfunction.

A nice summary of this is below
http://www.ncbi.nlm.nih.gov/pubmed/19695501

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