My laboratory is focused on uremic vascular biology as it applies to both Dialysis Vascular Access Dysfunction and the huge burden of cardiovascular morbidity and mortality in patients with end-stage renal disease (ESRD) and chronic kidney disease (CKD). We have focused on a bedside to bench to bedside approach and go all the way from pig and mouse (uremic and non-uremic) models of arteriovenous fistula (AVF) and graft (AVG) failure, to the development of novel devices to prevent AVF and AVG stenosis, to clinical trials that focus on devices to reduce AVF and AVG failure, and also identify the causes of sudden cardiac death in CKD and ESRD patients. Specific projects include:
- Linkages between hemodynamic shear and vascular stenosis in AVF and AVG stenosis in a pig model: This project focuses on the use of computational fluid dynamics to ultimately try and develop optimal flow profiles for AVFs and AVGs.
- Impact of uremia on AVF stenosis in a mouse model: This project explores the impact of uremia, inflammation, oxidative stress and endothelial dysfunction on AVF stenosis.
- Stents in AVF maturation failure (Device development project): This project focuses on the development of an innovative device (patent application in process) for reducing AVF maturation failure.
- Development of anti-infective therapies for Tunneled Dialysis Catheters: This project is developing new coatings and new approaches to reduce dialysis catheter infections.
- Molecular basis for endothelial dysfunction in CKD and ESRD patients: In this project we are examining blood and tissue specimens from hemodialysis patients for markers of oxidative stress and inflammation.
- Clinical trials to prevent AVF and AVG dysfunction: We are involved in multiple clinical trials to prevent dialysis vascular access dysfunction.