Changes in venous histology in chronic hemodialysis patients
Changes in venous histology in chronic hemodialysis patients
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DOI：
10.1016/s0272-6386(99)70396-3
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发表时间：
1999-10-01
影响因子：
13.2
通讯作者：
Babich, D
中科院分区：
文献类型：
--
作者：
Feinfeld, DA;Batista, R;Babich, D
由于大多数血液透析通路在静脉侧失败，我们研究了 15 名同意的终末期肾病患者建立通路期间获得的臂静脉样本。通过计算机辅助组织形态计量学检查静脉，结果与患者的临床数据相关。平均静脉内侧宽度为239+/-31μm，平均内膜宽度为6.0+/-0.9μm。透析时间超过 6 个月的 4 例患者的平均静脉内侧宽度为 358 +/- 74 μm，平均静脉内膜宽度为 9.2 +/- 1.2 μm，而透析时间小于 6 个月的 11 例患者分别为 196 +/- 23 μm 和 4.9 +/- 0.8 μm（P < 0.01）。接受血液透析的月数与静脉内膜宽度相关性良好（r = 0.79；P < 0.001），接受透析的月数与内膜宽度之间的相关性未达到统计学显着性。 4例糖尿病患者的内侧和内膜宽度与非糖尿病患者没有显着差异。血清甲状旁腺激素水平与内侧或内膜静脉宽度无关。我们得出的结论是，血液透析患者的静脉可能随着时间的推移而发生变化，导致层增厚，即使是不直接用于通路的静脉。这可能会影响后续血管通路的形成或存活。 (C) 1999 年，国家肾脏基金会 (National Kidney Foundation, Inc.)
Because most hemodialysis access fails at the venous side, we studied samples of brachial vein obtained during access creation in 15 patients with end-stage renal disease who gave consent. Veins were examined by computer-assisted histomorphometry, and the results correlated with the patients' clinical data. The mean venous medial width was 239 +/- 31 mu m, and mean intimal width was 6.0 +/- 0.9 mu m. Mean venous medial width was 358 +/- 74 mu m and mean venous intimal width was 9.2 +/- 1.2 mu m in the 4 patients who had been undergoing dialysis more than 6 months, compared with 196 +/- 23 mu m and 4.9 +/- 0.8 mu m, respectively, in the 11 patients undergoing dialysis less than 6 months (P < 0.01), The number of months undergoing hemodialysis correlated well with venous medial width (r = 0.79; P < 0.001), Correlation between number of months undergoing dialysis and intimal width did not reach statistical significance. Medial and intimal widths of the 4 patients with diabetes were not significantly different from those of the patients without diabetes. Serum parathyroid hormone level did not correlate with either medial or intimal venous width, We conclude there may be changes in the veins of hemodialysis patients with time that cause thickening of layers, even in veins not directly used for access. This may affect the creation or survival of subsequent vascular accesses. (C) 1999 by the National Kidney Foundation, Inc.