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Kidney Week

Abstract: TH-PO328

Secondary Hyperparathyroidism Stimulates Neointimal Hyperplasia of Arteriovenous Fistula in Mice

Session Information

  • Vascular Access - I
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Author

  • Liu, Chung-te, Division of Internal Medicine, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
Background

Arteriovenous fistula (AVF) is the preferred vascular access due to superior patency and lower infection rates. Nonetheless, its suboptimal maturation rate remains to be resolved. Previous clinical studies had shown that elevated parathyroid hormone (PTH) associated with AVF maturation failure. In thisstudy, we try to repeat this finding in a mice model of secondary hyperparathyroidism and AVF.

Methods

Chronic kidney disease (CKD) and secondary hyperparathyroidism were induced by feeding diet containing 0.2% adenine (adenine group) or 0.2% adenine and additional 2% phosphorus (high P group) in C57BL/6 mice. After 8 weeks of induction, AVF was created by aortocaval puncture. AVF was resected 6 weeks later. AVF was stained for α-smooth muscle actin (αSMA) to show neointimal hyperplasia. The severity of neointimal hyperplasia was expressed by ratio of area of αSMA/entire AVF.

Results

At the 8th week, renal function CKD was induced in adenine group and high P group (Figure 1A-B). Serum phosphorus level was insignificantly higher in high P group (Figure 1C). Compared with control group, serum PTH level was insignificantly higher in adenine group, while it was significantly higher in high P group (Figure 1D), indicating successful induction of secondary hyperparathyroidism in high P group. The severity of AVF neointimal hyperplasia was similar between control group and adenine group, while it was significantly more severe in high P group (Figure 1E-H). The above findings showed that secondary hyperparathyroidism may stimulate neointimal hyperplasia in AVF and play a role in AVF maturation failure.

Conclusion

The deleterious effect of PTH on AVF maturation shown will be confirmed by pharmaceutical suppression of PTH to reverse neointimal hyperplasia.