Rescuing Blood Access in a Chronic Kidney Disease Patient
Patient Background:
- Age: 45 years
- Medical Condition: Chronic Kidney Disease
Presentation:
A 45-year-old woman, known for “vascular access for dialysis” presented with issues concerning her vascular access for dialysis. Her left radiocephalic arteriovenous (A-V) fistula, which is crucial for her dialysis treatments, was not functioning as expected, leading to reduced blood flow. This problem was threatening her ability to continue regular dialysis and posed a significant risk to her long-term health.
Clinical Examination:
Upon examination, we found two primary issues affecting her fistula:
- Perianastomotic Stenosis: The connection point of the fistula had a long segment of narrowing, restricting blood flow.
- Draining Vein Thrombosis: A clot had formed in the vein responsible for carrying blood away from the fistula.
Treatment Plan:
To address these vascular complications, we recommended a fistuloplasty. This minimally invasive procedure involves widening the narrowed segment and treating the thrombosis to restore normal blood flow. The procedure was performed on an outpatient basis, allowing the patient to return home the same day.
Follow-up Care:
The patient has attended her follow-up appointments consistently for the past two months. We are pleased to report that her fistula is now functioning optimally. Blood flow has improved, and there have been no complications since the procedure.
Conclusion:
This case emphasizes the importance of early intervention and specialized care in managing vascular access issues in chronic kidney disease patients. By promptly addressing the problems with her fistula, we helped ensure that she could continue her dialysis treatments, improving her overall health and quality of life.
