Vascular Protective Effect of Rosuvastatin in Arteriovenous Fistula
Status:
Completed
Trial end date:
2019-01-31
Target enrollment:
Participant gender:
Summary
Background Arteriovenous (AV) fistula is the most common vascular access for long-term
hemodialysis in the end-stage renal disease (ESRD) patients. About 25% of these patients are
diabetes mellitus. However, the effects of hyperglycemia on the vascular function of
arteriovenous fistula are still remained unclear. Studies have shown that blood flow in the
AV fistula is significantly reduced in patients with diabetes mellitus. Diabetic patients
also require a longer period of time for the maturation of AV fistula, and have slightly
higher complication rate than non-diabetic patients. Statins have been widely shown to
mediate several important pleiotropic effects in the improvement of vascular endothelial
dysfunction, attenuation of inflammatory responses, stabilization of atherosclerotic plaques,
inhibition of vascular smooth muscle proliferation, and modulation of procoagulant activity
and platelet function.Our experimental studies in diabetic animals demonstrate that
administration of a water-soluble statin rosuvastatin significantly improves the fistula
flow, vascular function and luminal dilatation of AV fistula in diabetic rats by suppression
of vascular oxidative stress and inflammatory load.
Study hypothesis The central hypothesis of this research project is rosuvastatin mediates
pleiotropic protective effect on vascular endothelial function and suppresses the regional
pro-inflammatory reaction in the vasculature, therefore administration of rosuvastatin during
the perioperative period of creation of native AV fistulas in diabetic patients with ESRD may
potentiate the vascular function and reduce the primary failure rate of AV fistulae.