{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:15:55Z","timestamp":1790882155495,"version":"4.1.0"},"reference-count":8,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100012151","name":"sanming project of medicine in shenzen municipality","doi-asserted-by":"publisher","award":["No.SZSM202411016"],"award-info":[{"award-number":["No.SZSM202411016"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"abstract":"<jats:p>\n                    Arteriovenous grafts (AVGs) are important vascular access options for maintenance hemodialysis. Late AVG failure is commonly attributed to venous anastomotic stenosis, thrombosis, infection, or pseudoaneurysm formation. In contrast, intraluminal calcification is rarely recognized as a direct cause of access dysfunction. We report a 78\u2011year\u2011old woman with end\u2011stage kidney disease secondary to obstructive nephropathy and a history of hypertension, but without diabetes mellitus (BMI 24.65\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ), who had undergone left forearm AVG implantation in October 2016. The graft had been used for maintenance hemodialysis for 9\u2009years and 8\u2009months (from October 2016 to April 2026). During follow\u2011up, she underwent eight endovascular interventions for recurrent graft thrombosis and insufficient access flow, with one non\u2011tunneled central venous catheter placement. She had Chronic kidney disease-mineral and bone disorder (CKD-MBD) and was receiving calcimimetic therapy. In April 2026, she was admitted because of recurrent insufficient dialysis blood flow and progressive cannulation difficulty, characterized by marked resistance during needle insertion and a gritty sensation, often requiring multiple attempts to access the lumen. Ultrasound showed hyperechoic stenotic lesions within the graft, suggesting calcified graft stenosis. Surgical exploration revealed extensive firm whitish material adherent to the inner wall of the original graft, occupying approximately 80% of the lumen as estimated by gross visual inspection of the resected specimen. The diseased graft segment was resected, and a new prosthetic graft was tunneled along a revised subcutaneous route and anastomosed to the original anastomotic site. Histopathological examination confirmed calcium salt deposition within fibrous collagenous tissue. One month after surgery, the reconstructed AVG was successfully used for hemodialysis. This case highlights intraluminal calcification as a potential structural cause of late AVG failure in patients with CKD\u2011MBD.\n                  <\/jats:p>","DOI":"10.1177\/11297298261491195","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:56:36Z","timestamp":1790747796000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraluminal calcification as a potential cause of late arteriovenous graft failure in a patient with chronic kidney disease\u2013mineral and bone disorder"],"prefix":"10.1177","author":[{"given":"Tianjiao","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Nephrology, Center of Kidney and Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Center of Kidney and Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-5384","authenticated-orcid":false,"given":"Zhihua","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Center of Kidney and Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4264-6507","authenticated-orcid":false,"given":"Mingcheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Center of Kidney and Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Lok CE Huber TS Lee T et al. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis 2020 75(4 Suppl 2): S1\u2013S164. https:\/\/doi.org\/10.1053\/j.ajkd.2019.12.001 Erratum in: Am J Kidney Dis 2021; 77(4): 551. https:\/\/doi.org\/10.1053\/j.ajkd.2021.02.002","DOI":"10.1053\/j.ajkd.2021.02.002"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Lee T Roy-Chaudhury P. Advances and new frontiers in the pathophysiology of venous neointimal hyperplasia and dialysis access stenosis. Adv Chronic Kidney Dis 2009; 16(5): 329\u2013338. https:\/\/doi.org\/10.1053\/j.ackd.2009.06.009","DOI":"10.1053\/j.ackd.2009.06.009"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis Evaluation Prevention and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl (2011). 2017; 7(1): 1\u201359. https:\/\/doi.org\/10.1016\/j.kisu.2017.04.001 Erratum in: Kidney Int Suppl (2011). 2017; 7(3): e1. https:\/\/doi.org\/10.1016\/j.kisu.2017.10.001","DOI":"10.1016\/j.kisu.2017.10.001"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"Nelson AJ Raggi P Wolf M et al. Targeting vascular calcification in chronic kidney disease. JACC Basic Transl Sci 2020; 5(4): 398\u2013412. https:\/\/doi.org\/10.1016\/j.jacbts.2020.02.002","DOI":"10.1016\/j.jacbts.2020.02.002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","unstructured":"Miao P Tan ZL Tian R et al. Long-term patency and comparisons of venous outflow in hemodialysis forearm arteriovenous grafts. Vascular 2022; 30(2): 238\u2013245. https:\/\/doi.org\/10.1177\/17085381211012565","DOI":"10.1177\/17085381211012565"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","unstructured":"Brown TK Alharbi S Ho KJ et al. Prosthetic vascular grafts engineered to combat calcification: progress and future directions. Biotechnol Bioeng 2023; 120(4): 953\u2013969. https:\/\/doi.org\/10.1002\/bit.28316","DOI":"10.1002\/bit.28316"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Lejay A Bratu B Kuntz S et al. Calcification of synthetic vascular grafts: a systematic review. EJVES Vasc Forum 2023; 60: 1\u20137. https:\/\/doi.org\/10.1016\/j.ejvsvf.2023.05.013","DOI":"10.1016\/j.ejvsvf.2023.05.013"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Besseling PJ Krebber MM Fledderus JO et al. The effect of chronic kidney disease on tissue formation of in situ tissue-engineered vascular grafts. APL Bioeng 2023; 7(2): 026107. https:\/\/doi.org\/10.1063\/5.0138808","DOI":"10.1063\/5.0138808"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261491195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261491195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261491195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:47:33Z","timestamp":1790880453000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261491195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":8,"alternative-id":["10.1177\/11297298261491195"],"URL":"https:\/\/doi.org\/10.1177\/11297298261491195","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"11297298261491195"}}