Abstract: Arteriovenous fistulas (AVF) maturation failure remains a significant clinical problem faced by maintenance hemodialysis patients.At present, there is no effective treatment to prevent or treat it. The reason is usually results from venous stenosis at the AVF anastomosis, which is secondary to poor outward vascular remodeling and excessive venous intimal hyperplasia.Although the understanding of its pathophysiology has made great progress, it has not yet been transformed into effective treatment, and its mechanism needs to be further clarified so as to develop more specific therapies.This paper reviews the biological mechanism and clinical research progress of AVF maturation failure, and discusses the new areas of future research.

Key words: arteriovenous fistulas maturation failure, venous stenosis, vascular outward remodeling, intimal hyperplasia