Retarded hand growth due to a hemodialysis fistula in a young girl
| Autor: | E. A. Marlies Cornelissen, Frank van Hoek, Marc R. Scheltinga, Attila G. Krasznai |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty Adolescent Brachial Artery Fistula medicine.medical_treatment Elbow Ischemia Arteriovenous Shunt Surgical Renal Dialysis medicine.artery medicine Humans cardiovascular diseases Radial artery Brachial artery Child Renal disorder [IGMD 9] Cardiovascular diseases [NCEBP 14] medicine.diagnostic_test business.industry Angiography Hand medicine.disease Kidney Transplantation Surgery Transplantation medicine.anatomical_structure Nephrology Pediatrics Perinatology and Child Health Arm Female Hemodialysis business |
| Zdroj: | Pediatric Nephrology, 24, 2055-8 Pediatric Nephrology, 24, 10, pp. 2055-8 |
| ISSN: | 1432-198X 0931-041X |
| Popis: | Contains fulltext : 81670.pdf (Publisher’s version ) (Closed access) Long-term presence of an arteriovenous hemodialysis fistula (AVF) may lead to alterations in hand perfusion. In the case reported here, a 14-year-old girl developed pain associated with hand ischemia 5 years after a successful kidney transplantation. At age 8 years, she required a period of hemodialysis using an autogenous left upper arm AVF. Compared to the healthy right hand, a smaller ischemic left hand was observed in the presence of a patent AVF. Access flow was 1400 ml/min. Seldinger angiography demonstrated a stenotic brachial artery, and duplex measurements indicated a reversed blood flow in the radial artery. AVF ligation abolished the ischemic symptoms. Distal hypotension due to an impaired arterial inflow combined with a low resistance elbow AVF may result in chronic hypoperfusion of acral portions of the extremity and growth retardation. Access ligation is advised in children with an optimal renal transplant function and a patent elbow AVF suffering from lowered distal tissue perfusion. |
| Databáze: | OpenAIRE |
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