More than 500,000 U.S. patients have end stage renal disease (ESRD), and over 80% of them utilize hemodialysis. Problems with vascular access needed for hemodialysis are among the most frequent reasons for hospitalization of patients with ESRD. The direct cost of vascular access establishment and repair exceeds $700 million per year in the US. A significant problem for dialysis patients is the development of a functioning and durable vascular access, preferably an arteriovenous fistula (AVF). After creation, about 60% of AVFs fail to mature successfully for dialysis use. This is due to inadequate vasodilation and smooth muscle cell hyperplasia at the distal venous anastomosis. The Endomimetics bionanomatrix gel is being developed for use as a coating of the AVF at the time of creation, recruiting endothelial cells and enhancing appropriate vasodilation, both necessary for proper maturation. Additionally, Endomimetics’ bionanomatrix gel limits smooth muscle cell proliferation, which is also of benefit in that smooth muscle proliferation plays a significant role in AVF non-maturation. Endomimetics’ bionanomatrix gel is undergoing preclinical evaluation in collaboration with a group at the University of Alabama at Birmingham.
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