Vascular Protective Effect of Rosuvastatin in Arteriovenous Fistula

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.

Timeline

Start

2012-11

Primary completion

2018-12-31

Completion

2019-01-31

Publications

• Background Roan JN, Fang SY, Chang SW, Hsu CH, Huang CC, Chiou MH, Tsai YC, Lam CF. Rosuvastatin improves vascular function of arteriovenous fistula in a diabetic rat model. J Vasc Surg. 2012 Nov;56(5):1381-9.e1. doi: 10.1016/j.jvs.2012.03.243. Epub 2012 Jun 22.
• Background Fang SY, Roan JN, Lin Y, Hsu CH, Chang SW, Huang CC, Tsai YC, Lam CF. Rosuvastatin suppresses the oxidative response in the venous limb of an arteriovenous fistula and enhances the fistula blood flow in diabetic rats. J Vasc Res. 2014;51(2):81-9. doi: 10.1159/000357619. Epub 2014 Jan 15.

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