Weighing in on fistula failure.

Obesity, though not commonly reported as a cause of fistula failure, may influence fistula survival by making it difficult to cannulate the vein and possibly by releasing adipokines, such as interleukin-6, tumor necrosis factor-alpha, plasminogen activator inhibitor-1, or adiponectin, that modulate the development of neointimal hyperplasia and thrombosis leading to fistula failure.