Role and Mechanism of function of adipose derived mesenchymal stem cells in hemodialysis arteriovenous fistulas

In the US, ~726,000 patients have end-stage renal disease (ESRD) requiring chronic hemodialysis, which will double in the coming decade. Optimal hemodialysis and clearance of uremic toxins requires a vascular access through an arteriovenous fistula (AVF). Unfortunately, AVFs fail due to venous neointimal hyperplasia (VNH) that leads to venous stenosis formation. AVF patency at one year is estimated to be approximately 62%. Currently, no effective and durable therapies prevent venous stenosis formation. The present proposal will use adipose derived mesenchymal stem cells (AMSCs) to prevent AVF failure. We will determine how adipose derived mesenchymal stem cells (AMSCs) work. We will investigate whether AMSC application can be repeated. Finally, we will use advanced imaging using Pulse wave velocity (PWV) and Young's Modulus to assess fibrosis and function after AMSC treatment. The proposed studies will help us develop therapies aimed at improving the function of AVFs in patients from Minnesota.