Approximately 500,000 Americans with end-stage renal disease rely on hemodialysis to survive. Hemodialysis requires repeated access to the blood. Failure to maintain adequate access to the vasculature is a major cause of medical complications and, potentially, death for these patients.A new study in The American Journal of Pathology provides information about the mechanisms underlying failure of the most common type of hemodialysis vascular access, the arteriovenous fistula. Despite being the preferred approach, there is currently limited understanding of the mechanisms involved in fistula maturation failure…