scholarly journals Endovascular Balloon Treatment of a Failing Arteriovenous Fistula. A Case Report.

2021 ◽  
Vol 4 (4) ◽  
pp. 01-03
Author(s):  
Emmanuel Edafe
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Normal Serum ◽  
Tips And Tricks ◽  
Av Fistula ◽  
Essentially Normal ◽  
Life Saving ◽  
Artery Disease ◽  
Stage Renal Disease ◽  
End Stage

BACKGROUND: Arterio-venous (AV) fistula is created for patients requiring renal replacement therapy (hemodialysis and hemofiltration). A failing A-V fistula requires urgent treatment to keep it patent. Understanding the simple tips and tricks will contribute to the quality of life for the patient with end-stage renal disease and reducing radiation dose to the operator. CASE SUMMARY: A 77 year old male with end-stage renal disease, hypertension and coronary artery disease. He has been on regular haemodialysis after A-V fistula (left forearm) was constructed in 2013. He presented with 2 weeks history of A-V fistula occlusion. Examination was essentially normal. Serum sodium=136mmol/l, potassium=5.5mmol/l urea=100mg/l, creatinine=3.5mg/dl. The Doppler scan showed 50 % stenosis just proximal to the anastomosis with calcification. Percutenous arteriography and venography was done with non-compliance balloon (3x12mm) up to 24 atm . The post procedure venography showed restoration of flow across the fistula. CONCLUSION: Endovascular treatment of a failing A-V fistula can be life saving. The simple tips and tricks of using the groin route, reducing the concentration of contrast and maneuver devices may contribute to safety and reduce radiation to the operator.

scholarly journals Premature atherosclerosis and acute coronary syndrome in a child with end-stage renal disease

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Tülay Becerir ◽  
Münevver Yılmaz ◽  
İlknur Girişgen ◽  
Neslihan Yılmaz ◽  
Dolunay Gürses ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Left Coronary Artery ◽  
Premature Atherosclerosis ◽  
Case Presentation ◽  
Coronary Syndrome ◽  
Life Saving ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background Although acute coronary syndrome is rare in children, it is the most important cause of mortality in children with end-stage renal disease. Case presentation Here, a 16-year-old pediatric patient, who has been on dialysis since the age of 3, and who was diagnosed with acute coronary syndrome and placed an emergency percutaneous transcatheter stent in the left anterior descending branch of the left coronary artery is presented. It is important that the present patient does not have any electrocardiography findings in favor of cardiovascular disease and that he cannot fully explain the complaint of chest pain due to his mental retardation. Conclusions Early detection of acute coronary syndrome is life-saving, especially in children with chronic kidney disease.

scholarly journals CUT OFF VALUE OF PROCALCITONIN IN END STAGE RENAL DISEASE PATIENTS WITHOUT INFECTION

2021 ◽  
Vol 5 (02) ◽  
Author(s):  
Naila Asif ◽  
Samina Shamim ◽  
Shafqat Waqar Khanzada ◽  
Muhammad Rizwan
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Serum Levels ◽  
Acute Phase Reactant ◽  
Normal Serum ◽  
Maintenance Hemodialysis ◽  
Maintenance Haemodialysis ◽  
Reactive Protein ◽  
Stage Renal Disease ◽  
End Stage

OBJECTIVE: To determine cut off value of procalciton (PCT) in aseptic end stage renal disease patients undergoing haemodialysis. BACKGROUND: Haemodialysisis considered as a proinflammatory state and therefore associated with release of inflammatory cytokines and acute phase reactant proteins. The conventional laboratory markers (C-reactive protein, erythrocyte sedimentation rate) are efficient tools for the diagnosis of infection in patients with normal kidney functions. However they can be nonspecifically elevated in patients on haemodialysis and only reflect inflammatory response not associated with infection. PCT is considered a very important biomarker in differentiating infections from inflammation. The study was undertaken to evaluate normal serum levels of PCT in patients undergoing HD.PATIENTS AND METHOD: The study included 82 end-stage renal failure patients without evidence of systemic or localized infection undergoing maintenance haemodialysis. RESULTS: In our study, the PCT concentrations showed a mean of .622ng/ml in patients on maintenance hemodialysis without signs of infection. CONCLUSION:The study suggests that serum PCT at a cutoff value of .62ng/ml should be considered normal in aseptic haemodialysis patients. KEYWORDS: Procalcitonin, haemodialysis, sepsis

General Surgery in Patients with End-Stage Organ Disease

2015 ◽  
Author(s):  
Amy R. Evenson ◽  
Ramanathan M. Seshadri ◽  
Jonathan P. Fryer
Keyword(s):  
United States ◽  
Liver Disease ◽  
Renal Disease ◽  
General Surgery ◽  
End Stage Renal Disease ◽  
The United States ◽  
Av Fistula ◽  
End Stage Liver Disease ◽  
Stage Renal Disease ◽  
End Stage

The number of patients with end-stage organ disease in the United States is substantial. Patients with end-stage organ disease are susceptible to all of the surgical problems seen in general surgical practice, with the added comorbidities associated with their organ failure. Hence, understanding of the principles of perioperative patient management is important as part of a general surgery practice. The chapter contains details on general and peripheral vascular surgical procedures, including dialysis access for patients with end-stage renal disease. Details on management of abdominal hernias, cholelithiasis, and disorders of the intestine in patients with end-stage liver disease are provided. Table 1 discusses the advantages and disadvantages of arteriovenous (AV) fistulas versus AV grafts. Table 2 describes “the rule of 6’s” for mature AV fistula. Table 3 has information on potential barriers to peritoneal dialysis. Table 4 is the Child-Pugh-Turcotte classification of severity of liver disease. Table 5 discusses the factors affecting the decision to operate and timing of operation in patients with end-stage liver disease. Figure 1 shows the increasing incidence of end-stage renal disease in the United States. Figure 2 is the five-stage classification system for chronic kidney disease. Figure 3 illustrates the various options for upper extremity AV fistula. This review contains 3 figures, 5 tables, and 68 references.

scholarly journals Extracorporeal Apheresis Via AV Fistula in Multiple Myeloma Patients with End Stage Renal Disease

2016 ◽  
Vol 22 (3) ◽  
pp. S443-S444
Author(s):  
Jennifer Bourke ◽  
Tomer M. Mark ◽  
Jeffrey Silberzweig ◽  
Uvannie Enriquez ◽  
Koen van Besien ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Av Fistula ◽  
Stage Renal Disease ◽  
End Stage
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