Hemodialysis vascular access failure: novel pathophysiological mechanisms and therapeutic strategies

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Hemodialysis vascular access failure: novel pathophysiological mechanisms and therapeutic strategies

Type: Doctoral Thesis
Title: Hemodialysis vascular access failure: novel pathophysiological mechanisms and therapeutic strategies
Author: Bezhaeva, T.
Issue Date: 2019-03-07
Keywords: Hemodialysis vascular access
Arteriovenous fistula
In situ vascular tissue engineering
Abstract: Dysfunction of vascular access remains a major clinical problem responsible for high morbidity and substantial health care costs in patients required chronic hemodialysis treatment. Despite the magnitude of this clinical problem, there have been no major novel therapeutic interventions in the field of hemodialysis access for the past few decades. The work described in this thesis aimed to further understand the pathobiology of vascular access dysfunction and identify new therapeutic candidates to improve the current status of hemodialysis vascular access.We first explored the role of inflammation in vascular remodeling upon arteriovenous fistula (AVF) surgery. Based on the evolving concept of the importance of the outward remodeling (OR) in AVF maturation next, we evaluated the role of relaxin pathway as potential contributor to OR in AVF maturation. In parallel with testing new therapeutics to improve maturation and patency of native AVFs, our group is working on developing tissue engineered blood vessels (TEBVs) which could offer a suitable alternative for arteriovenous conduits. In collaboration with University of California, Los Angeles, we performed a lineage tracing to study the contribution of bone marrow derived cells to TEBV formation and the impact of chronic kidney disease onto the process of TEBV formation.
Promotor: Supervisor: Zonneveld A.J. van, Quax P.H.A. Co-Supervisor: Rotmans J.I.
Faculty: Medicine / Leiden University Medical Center (LUMC)
University: Leiden
Uri: urn:isbn:9789463802024
Handle: http://hdl.handle.net/1887/68702
 

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