Pathological changes of blood vessels near internal fistula in chronic kidney disease patients at stage 5

Objective To study the pathological changes of radial artery and cephalic vein in patients with chronic kidney disease at stage 5 (CKD5). Method We took samples of radial artery and cephalic vein for pathological study from 32 CKD5 cases (CKD group) during the internal fistula surgery. We also took ‘normal’ blood vessel samples at the same site from amputated limbs of 10 cases (control group) with the age comparable to the CKD patients. Result In CKD group, radial arteries showed fibrosis in 4 cases, plaque formation in 11 cases, and calcification foci in 7 cases, and cephalic veins were found to have fibrosis in 10 case, plaque formation in 8 cases, and calcification foci in 2 cases. In contrast in control group, there were no abnormalities in intimal, medial and adventitial layers in radial arteries and cephalic veins (? 2 =8.376,? 2 =9.557,P=0.003,P=0.002). Conclusion Apparent pathological changes in radial artery and cephalic vein existed in CKD group. The main pathological change was calcification in radial arteries, and was fibrosis and stenosis in cephalic veins. Therefore, internal fistula surgery should be carried out earlier to obtain an internal fistula of high quality for blood access.