Evaluating Animal Models for Improved Hemodialysis Vascular Access: A Focus on Arteriovenous Fistula

Abstract

Hemodialysis (HD) is the primary form of renal replacement therapy for renal failure, and autologous arteriovenous fistula (AVF) is the preferred vascular access for long-term hemodialysis. However, AVFs are prone to stenosis during use, leading to fistula dysfunction and failure to meet the high blood flow rates required for dialysis, thereby diminishing the quality of life of patients. Re-interventions following stenosis often fail to address the underlying issues. Therefore, exploring the pathophysiological mechanisms, diagnostic and therapeutic approaches, and preventive measures for AVF stenosis through animal experiments is a crucial scientific endeavor. This review highlights the importance of autologous AVF animal models. The primary focus of this review is to discuss the current situation, ethics, objectives, and requirements of animal experimentation, and to briefly describe the commonly used animals suitable for creating AVF models, surgical methods, and current research outcomes in the scientific community. This article aims to review the role of animal models in studies on autologous arteriovenous fistula for hemodialysis.

Figure 1

Three common vascular anastomosis methods. (A) End-to-side. (B) Side-to-side. (C) End-to-end. Blue: Vein, red: Artery.

Figure 2

Three commonly used methods for inducing renal failure. (A1) Partial nephrectomy – Week 1: Approximately two-thirds of the kidney was resected. (A2) Partial nephrectomy - Week 2: The right kidney was resected. (B) Renal artery embolization: The renal artery was embolized to induce ischemia. (C) Induction by diet or drugs: A diet rich in adenine or specific drugs was used to induce renal failure.