Matrix metalloproteinase 9 (MMP-9) knockout downregulated CD44 and RAC-alpha serine/threonine-protein kinase (Akt) and extracellular signal-regulated kinases (ERK) phosphorylation in arteriovenous (AV) fistula venous segment. (A) Western blotting was done for evaluating the protein expression in AV fistula venous segment. (B) One-week post AV fistula creation, CD44 expression was increased in wild-type (WT) mice, which was reversed by MMP-9 knockout. (C) Akt phosphorylation was also increased after AV fistula creation and attenuated by MMP-9 knockout. (D) Phospho-ERK level was significantly decreased in MMP-9−/− mice. *** p < 0.001, **** p < 0.0001. Data presented as mean ± SEM. Data analyzed by one-way analysis of variance (ANOVA) followed by Bonferroni post hoc analysis, n = 6 in each group. CTL, control.