Abstract: Objective Vascular access (VA) dysfunction is a major clinical complication in maintenance hemodialysis(HD)patients, and is closely related to the outcome of dialysis. Here we evaluated the role of microinflammation in VA dysfunction in HD patients. Methods Forty-seven HD patients(male 35, female12) without acute inflammatory reaction in the observation period were enrolled in this study. They were divided into three groups: group 1 (N=15), patients beginning hemodialysis using an arteriovenous fistula; group 2 (N=18), patients having been treated with HD for a period of time with functional VA; group 3 (N=14), patients having been treated with HD for a period of time with dysfunctional VA. Biochemical parameters were observed in the three groups. Serum TNF-α, IL-6 and MCP-1 were determined by ELISA. High-sensitivity C-reactive protein (hs-CRP) was determined by latex-enhanced immuno-nephelometric method. Tissues of radial artery were taken from patients of group 1 and group 3 for histological study. Expression of CD68 and MCP-1 in the radial arteries was determined by immunohistochemistry. Results Serum hs-CRP, TNF-α and IL-6 were significantly higher in group 3 than in group 1 and 2. Intimal thickness of radial arteries and the expression of CD68 and MCP-1 in arterial walls were also significantly increased in group 3 as compared with those of group1. Moreover, serum hs-CRP was significan-tly correlated to intimal thickness and the expression of CD68 and MCP-1 in arterial walls (P＜0.01). However, there were no differences in age, blood pressure and lipid level among the three groups. Conclusion This study suggests that microinflammation may be involved in the VA dysfunction in HD patients.

Key words: Uremia, Vascular access, Hemodialysis