American Journal of Internal Medicine
Volume 3, Issue 4, July 2015, Pages: 153-155
Received: May 23, 2015;
Accepted: Jun. 1, 2015;
Published: Jun. 16, 2015
Views 4325 Downloads 133
Befa Noto Kadou Kaza, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Kossi Akomola Sabi, Department of Nephrology, Dialysis of Sylvanus Olympio University Hospital, Lome, Togo
Ali Hissein Mahamat, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Yasminatou Aminata Wendkuuni Bikinga, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Mays Hadi Al Torayhi, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Eyram Yoan Makafui Amekoudi, Department of Nephrology, Dialysis of Sylvanus Olympio University Hospital, Lome, Togo
Comlan Mawuko Blitti, Department of Vascular, Surgery of University Hospital, Fes, Morocco
Keyit Leonard Yegha, Department of Nephrology, Dialysis of Sylvanus Olympio University Hospital, Lome, Togo
Ghislaine Medkouri, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Mohamed Gharbi Benghanem, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Benyounes Ramdani, Department of Nephrology, Dialysis and Kidney Transplantation of IbnRochd University Hospital, Casablanca, Morocco
Introduction: Aortic aneurysm (AA) is a frequent pathology in the general population. Patients at risk are those who have factors that can lead to arterial degeneration mainly high blood pressure (HBP), smoking and inflammation. In patients with chronic kidney failure (CKF) especially those who undergo hemodialysis who have almost all these risk factors, very little attention on the study of AA is accorded them. We reported two cases of AA in hemodialysis patients. Observation: Case 1. Fifty two (52) years old male, with past history of HBP since 21years of age, declared to have a terminal CKF from an undetermined nephropathy that has been on hemodialysis since 15 years. After 6 years of hemodialysis he presented an acute coronary syndrome associated with a painful abdominal syndrome which led to the diagnosis of aneurysm of the ascending aorta that measured 5cm in diameter. Therapeutic abstinence was adopted with annual follow up using chest angio-CT scan and thrombosis prevention using platelet aggregation inhibitors. The lesion is stable since 9 years. Case 2. Forty two (42) years old male, with no particular past history. Terminal CKF from an undetermined nephropathy that has been on hemodialysis since 6 years. On the 5th year of hemodialysis he presented a painful abdominal syndrome with no gas no food passage that lead to the diagnosis of abdominal aorta aneurysm of 4.7cm diameter and a height of 12cm. Atherapeutic abstinence was adopted with follow up and anti thrombolytic therapy put. After one year of evolution, the patient developed a mesenteric artery ischemia that on exploration showed a fissuration of the aneurysm that lead to the death of the patient. Conclusion: Aortic aneurysm in CKF has been a concerned in patients who had in most cases polycystic kidney disease who were not yet on hemodialysis. AA is a reality in patients on hemodialysis. Its evolution is uncertain and at times it is fatal. Screening for it is obligatory.
Befa Noto Kadou Kaza,
Kossi Akomola Sabi,
Ali Hissein Mahamat,
Yasminatou Aminata Wendkuuni Bikinga,
Mays Hadi Al Torayhi,
Eyram Yoan Makafui Amekoudi,
Comlan Mawuko Blitti,
Keyit Leonard Yegha,
Mohamed Gharbi Benghanem,
Aortic Aneurysm in Hemodialysis Patients: A Report of Two Cases, American Journal of Internal Medicine.
Vol. 3, No. 4,
2015, pp. 153-155.
Rodin MB, Daviglus ML, Wong GC, Liu K, Garside DB, Greenland P, Stamler J. Middle age cardiovascular risk factors and abdominal aortic aneurysm in older age. Hypertension 2003; 42:61–68.
Blanchard JF, Armenian HK, Friesen PP. Risk factors for abdominal aortic aneurysm: results of a case-control study. Am J Epi¬demiol. 2000; 151: 575–583.
Franks PJ, Edwards RJ, GreenhalghRM, Powell JT. Risk factors for abdominal aortic aneurysms in smokers. Eur J VascEndovasc Surg.1996; 11: 487–492.
Hobbs SD, Claridge MW, Quick CR, Day NE, Bradbury AW, Wilmink AB. LDL cho¬lesterol is associated with small abdominal aortic aneurysms. Eur J VascEndovascSurg.2003; 26: 618 –622.
Lee AJ, FowkesFG, Carson MN, Leng GC, Allan PL. Smoking, atherosclerosis and risk of abdominal aortic aneurysm. Eur Heart J.1997; 18:671–676.
Singh K, BonaaKH, Jacobsen BK, Bjork L, Solberg S. Prevalence of and risk factors for abdominal aortic aneurysms in a population-based study: the Tromso Study. Am J Epidemiol. 2001;154:236–244.
Tornwall ME, Virtamo J, HaukkaJK, Albanes D, HuttunenJK. Life-style factors and risk for abdominal aortic aneurysm in a cohort of Finnish male smokers. Epidemiol¬ogy. 2001;12:94–100.
Vardulaki KA, Walker NM, Day NE, Duffy SW, Ashton HA, Scott RA. Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br J Surg. 2000;87:195–200.
Al-Omran M., Verma S., Lindsay T.F., Weisel R.D., Sternbach Y. Clinical Decision Making for Endovascular Repair of Abdominal Aortic Aneurysm Circulation 2004; 110: e517-e523 (Serie Clinical Update).
Johnston KW. Multicenter prospective study of nonruptured abdominal aortic aneurysms. II: Variables predicting morbidity and mortality. J VascSurg 1989; 9: 437-47.
Joseph MG, McCollum PT, Lusby RJ. Abnormal preoperative creatinine levels and renal failure following abdominal aortic aneurysm repair. Aust N Z J Surg 1989; 59: 539-41.
Atsushi Guntani, JyunOkadome, EisukeKawakubo, Ryoichi Kyuragi, KazuomiIwasa, RyotaFukunaga, SoseiKuma, Takuya Matsumoto, Jin Okazaki,and Yoshihiko Maehara, Clinical Results of Endovascular Abdominal AorticAneurysm Repair in Patients with Renal Insufficiency without Hemodialysis Ann Vasc Dis Vol.5, No.2; 2012; pp 166–171
Takagi H, Umemoto T. Abdominal aortic aneurysm and autosomal-dominant polycystic kidney disease. Kidney Int 2005;67:376.
Kato A, Takita T, Furuhashi M, Maruyama Y, Hishida A. Abdominal aortic aneurysms in hemodialysis patients with autosomal dominant polycystic kidney disease. Nephron 2001;88:185-6.
Nacasch N, Werner M, Golan E, Korzets Z. Arterial dissections in au-tosomal dominant polycystic kidney disease-chance association or part of the disease spectrum? Clin Nephrol 2010;73:478-81
GajdosC, Hawn MT, Kile D, Henderson WG, Robinson T, McCarter M, Nehler MThe risk of major elective vascular surgical procedures in patients with end-stage renal disease.Ann Surg. 2013;257(4):766-73.
Yuo TH, Sidaoui J, Marone LK, Avgerinos ED, Makaroun MS, Chaer RA. Limited survival in dialysis patients undergoing intact abdominal aortic aneurysm repair. J Vasc Surg. 2014;60(4):908.