While arteriovenous fistulas (AVFs) are the optimal route of access for hemodialysis in terms of duration of patency and infection rates, they can still fail due a variety of reasons. Most commonly, AVF failure is due to venous stenotic lesions, resulting in reduced blood flow rate across the fistula. Fistulograms are often used to investigate cases of symptomatic or poor fistula function. This case discusses a 71-year-old man with a mature brachiocephalic AVF who presented with severe right upper extremity edema, and had a negative fistulogram, despite a severe stenosis in his AVF.
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http://dx.doi.org/10.1016/j.radcr.2023.12.027 | DOI Listing |
Cureus
December 2024
Internal Medicine, Hurley Medical Center, Flint, USA.
Catheter ablation procedure for symptomatic atrial fibrillation is an established treatment. Cardiac tamponade is one of the several complications associated with atrial fibrillation ablation. We present the case of a 60-year-old male with a past medical history of end-stage renal disease (ESRD) on hemodialysis, hypotension on midodrine, atrial fibrillation status post-ablation a week prior, and a cerebrovascular accident who presented to the emergency department with complaints of weakness, nausea, vomiting, confusion and some syncopal episodes for the past few days.
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December 2024
Division of Nephrology, Toho University Sakura Medical Center, Sakura, JPN.
Persistent hiccups are rare but can serve as an early symptom of underlying conditions, including pulmonary infections and cerebrovascular disorders. This case highlights hiccups as a presenting symptom of bronchopneumonia in a hemodialysis patient and explores the effective use of chlorpromazine and Hange-koboku-to (HKT) as symptomatic therapies. Given the potential association of hiccups with neurological conditions, this case underscores the need for comprehensive diagnostic evaluation.
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March 2025
Department of Family Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
Cureus
November 2024
Nephrology, Colchester Hospital, Colchester, GBR.
Calciphylaxis is a rare and serious disorder almost exclusively seen in patients on dialysis or those with advanced chronic kidney disease (CKD) not on dialysis and is associated with very high mortality. We present the case of a 50-year-old male with a background of end-stage renal disease (ESRD) compliant with dialysis, parathyroid adenoma, secondary hyperparathyroidism, and high body mass index (BMI). Whilst receiving 31 doses of intravenous sodium thiosulphate (STS) over an 11-week period, the patient underwent surgical debridement of multiple painful ulcerative lesions in his lower abdomen and left thigh and then subsequently a subtotal parathyroidectomy at 70 days from admission.
View Article and Find Full Text PDFAm J Case Rep
December 2024
Division of Emergency Medicine, Toho University Sakura Medical Center, Sakura, Chiba, Japan.
BACKGROUND Toluene poisoning can occur as a result of occupational exposure in industries such as painting, as well as through misuse, leading to complications such as neurological symptoms due to the accumulation of the metabolic byproduct of hippuric acid and metabolic acidosis. However, the exact mechanisms remain unclear. Hippuric acid is not removed by dialysis, so urinary excretion plays a central role.
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