Characterization of a model of an arteriovenous fistula in the rat: The effect of L-NAME

Anthony J. Croatt, Joseph Peter Grande, Melissa C. Hernandez, Allan W. Ackerman, Zvonimir S Katusic, Karl A Nath

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Abstract

Vascular access dysfunction contributes to the mortality of patients undergoing chronic hemodialysis. The present study analyzed the changes that evolve in a femoral arteriovenous fistula in the rat. The venous segment of this model exhibited, at 1 week, activation of pro-inflammatory transcription factors and up-regulation of pro-inflammatory, proliferative , procoagulant, and profibrotic genes; and at 4 weeks, the venous segment displayed neointimal hyperplasia, smooth muscle proliferation, and thrombus formation. These changes were accompanied by endothelial (e) nitric oxide synthase (NOS) and inducible (i) NOS up-regulation. The administration of N G-nitro-L-arginine methyl ester, an inhibitor of NOS activity, increased venous neointimal hyperplasia and pro-inflammatory gene expression (monocyte chemoattractant protein-1 and cytokine-induced neutrophil chemoattractant-1), increased systolic blood pressure, and decreased blood flow through the fistula. In another hypertensive model, the rat subtotal nephrectomy model, venous neointimal hyperplasia in the arteriovenous fistula was also exacerbated. We conclude that this arteriovenous fistula model recapitulates the salient features observed in dysfunctional, hemodialysis arteriovenous fistulas, and that venous neointimal hyperplasia is exacerbated when this model is superimposed in two different models of systemic hypertension. Since the uremic milieu contains increased amounts of asymmetric dimethylarginine, we speculate that such accumulation of this endogenous inhibitor of NOS, by virtue of its pressor or nitric oxide-depleting effects , or a combination thereof, may contribute to the limited longevity of arteriovenous fistulas used for hemodialysis.

Original languageEnglish (US)
Pages (from-to)2530-2541
Number of pages12
JournalAmerican Journal of Pathology
Volume176
Issue number5
DOIs
StatePublished - May 2010

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NG-Nitroarginine Methyl Ester
Arteriovenous Fistula
Hyperplasia
Renal Dialysis
Nitric Oxide Synthase
Up-Regulation
Blood Pressure
Chemokine CCL2
Nitric Oxide Synthase Type III
Chemotactic Factors
Nitric Oxide Synthase Type II
Thigh
Nephrectomy
Fistula
Smooth Muscle
Blood Vessels
Nitric Oxide
Neutrophils
Thrombosis
Transcription Factors

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Characterization of a model of an arteriovenous fistula in the rat : The effect of L-NAME. / Croatt, Anthony J.; Grande, Joseph Peter; Hernandez, Melissa C.; Ackerman, Allan W.; Katusic, Zvonimir S; Nath, Karl A.

In: American Journal of Pathology, Vol. 176, No. 5, 05.2010, p. 2530-2541.

Research output: Contribution to journalArticle

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