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KMID : 0359920060250050789
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Korean Journal of Nephrology
2006 Volume.25 No. 5 p.789 ~ p.795
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Markers of Inflammation in the Stenosis of Hemodialysis Vascular Access
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Kim Su-Hyun
Kim Seung-Jung
Kang Duk-Hee
Choi Kyu-Bok
Yoon Kyun-Il
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Abstract
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Background : Histologically, vascular access stenosis is similar to the atherosclerotic lesion such as neointimal hyperplasia. However, the pathogenesis is not completely understood. The development of Inflammation and atherogenesis in hemodialysis population has been well recognized and is known as the malnutrition-inflammation-atherosclerosis (MIA) syndrome. We, therefore, examined the relationship between the vascular access stenosis and proinflammatory molecules in hemodialysis patients
Methods : Seventy-two regularly dialyzed patients were observed and the serum levels of the proinflammatory cytokines (IL-6, TNF-α and INF- γ) were measured by ELISA. Patients were followed until the earliest date of death, modality change or loss to follow up.
Results : Vascular access stenosis was developed in thirty-five patients, and their mean duration of access survival was 22.7±37.6 months. In thirtyseven patients, vascular access remained patent during the study period (mean follow up; 70.9±46.6 months). In patients with autologous AV fistula, multivariate Cox regression analysis showed a significant contribution of INF-γ to vascular access stenosis (Hazard ratio 1.024, p=0.044). In patients with AV graft, there was no significant relation between inflammatory cytokines and graft stenosis. There were positive correlations between the level of TNFα and ferritin, and between transferrin and albumin. CRP and ferritin were negatively correlated with albumin and transferrin.
Conclusions : Markers of inflammation were significantly associated with nutrition. And INF-γ, one of the inflammatory cytokines, was related to the vascular access stenosis. (Korean J Nephrol 2006; 25(5):789-795)
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KEYWORD
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Inflammatory cytokines, INF-γ, Vascular access stenosis
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