{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:05:19Z","timestamp":1777935919044,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T00:00:00Z","timestamp":1525824000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Several histologic features have been identified in the upper-extremity arteries and veins of patients with advanced chronic kidney disease, which may affect arteriovenous fistula maturation. However, it is unclear whether these chronic kidney disease vascular features are abnormal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We obtained upper-extremity arterial and venous specimens from 125 advanced chronic kidney disease patients undergoing arteriovenous fistula creation and from 15 control subjects. We quantified medial fibrosis, micro-calcification, and intimal hyperplasia with appropriate histology stains. We characterized medial collagen fiber configuration in second-harmonic-generation microscopy images for the fiber anisotropy index and the dominant fiber direction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The advanced chronic kidney disease patients were significantly younger than control subjects (53\u2009\u00b1\u200914\u2009years vs 76\u2009\u00b1\u200911\u2009years, p\u2009&lt;\u20090.001). After controlling for age, the chronic kidney disease patients had greater arterial medial fibrosis (69%\u2009\u00b1\u200914% vs 51%\u2009\u00b1\u200910%, p\u2009&lt;\u20090.001) and greater arterial micro-calcification (3.03%\u2009\u00b1\u20095.17% vs 0.01%\u2009\u00b1\u20090.03%, p\u2009=\u20090.02), but less arterial intimal thickness (30\u2009\u00b1\u200925\u2009\u00b5m vs 63\u2009\u00b1\u200925\u2009\u00b5m, p\u2009&lt;\u20090.001), as compared to control subjects. The anisotropy index of medial collagen fibers was lower in both arteries (0.24\u2009\u00b1\u20090.10 vs 0.44\u2009\u00b1\u20090.04, p\u2009&lt;\u20090.001) and veins (0.28\u2009\u00b1\u20090.09 vs 0.53\u2009\u00b1\u20090.10, p\u2009&lt;\u20090.001) in chronic kidney disease patients, indicating that orientation of the fibers was more disordered. The dominant direction of medial collagen fibers in chronic kidney disease patients was greater in the arteries (49.3\u00b0\u2009\u00b1\u200923.6\u00b0 vs 4.0\u00b0\u2009\u00b1\u20092.0\u00b0, p\u2009&lt;\u20090.001) and the veins (30.0\u00b0\u2009\u00b1\u200919.6\u00b0 vs 3.9\u00b0\u2009\u00b1\u20092.1\u00b0, p\u2009&lt;\u20090.001), indicating that the fibers in general were aligned more perpendicular to the lumen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Advanced chronic kidney disease is associated with several abnormalities in vascular histology and collagen fiber configuration. Future research is needed to investigate whether these abnormalities affect the maturation outcomes of arteriovenous fistulas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1129729818773305","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T01:25:18Z","timestamp":1525915518000},"page":"31-40","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Abnormalities of vascular histology and collagen fiber configuration in patients with advanced chronic kidney disease"],"prefix":"10.1177","volume":"20","author":[{"given":"Michael","family":"Allon","sequence":"first","affiliation":[{"name":"Division of Nephrology, The University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvio H","family":"Litovsky","sequence":"additional","affiliation":[{"name":"Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason Chieh Sheng","family":"Tey","sequence":"additional","affiliation":[{"name":"Division of Nephrology & Hypertension, Department of Internal Medicine, The University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad A","family":"Sundberg","sequence":"additional","affiliation":[{"name":"Division of Nephrology & Hypertension, Department of Internal Medicine, The University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, The University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Diabetes Complications & Metabolism, Beckman Research Institute, City of Hope, Duarte, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Fang","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department of Medicine, The University of Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred K","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Nephrology & Hypertension, Department of Internal Medicine, The University of Utah, Salt Lake City, UT, USA"},{"name":"Medical Service, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA"},{"name":"Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Ting","family":"Shiu","sequence":"additional","affiliation":[{"name":"Division of Nephrology & Hypertension, Department of Internal Medicine, The University of Utah, 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