Role Of Oxidative Stress In Arteriovenous Fistula Thrombosis

Background:This study was designed to examine the protein expression of oxidative stress and its signaling pathway in human vein segments of AVF with or without thrombosis in chronic hemodialysis (CHD) patients-Methods:We studied eighteen CHD subjects with AVF thrombosis undergoing AV reconstruction (thrombosis group), and twenty CHD subjects without AVF thrombosis served as controls. The expression of oxidative stress (NOX-4, SOD, rac-2, and HO-1) and its signaling pathway (p-FoxO1, p-FoxO3a, PI3K, and P-22) was examined by immunoblotting.Results:Compared with the control group, the expression of NOX-4, SOD-1, SOD-2, rac-2, and HO-1 were significantly increased in the AVF thrombosis group. The increase in oxidative stress parameters was accompanied by activation of p-FoxO1, p-FoxO3a, PI3K, and P-22. A linear regression analysis showed that expression of oxidative stress was correlated with p-FoxO1 (r=0.658, P<0.01) and PI3K expression (r=0.769, P<0.01). Multiple logistic regression analysis revealed that expression of oxidative stress was independent predictors of AVF thrombosis (odds ratio,2.54 and 3.13; 95% confidence interval,3.76 to 5.56; P<0.05).Conclusions:Our findings suggest that activation of oxidative stress and its signaling pathway may play a role in AVF thrombosis in CHD patients.