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伴有动静脉内瘘的肾移植患者出现可逆性肺动脉高压。

Reversible pulmonary hypertension in a kidney transplant with patent A-V fistula.

作者信息

Kabitz Hans-Joachim, Walterspacher Stephan, Geyer Marcel, Fischer Karl-Georg, Huber Tobias B, Muendlein Eckehard, Walz Gerd

机构信息

Department of Pneumology , University Hospital Freiburg , Freiburg , Germany.

Department of Nephrology , University Hospital Freiburg , Freiburg , Germany.

出版信息

Clin Kidney J. 2012 Aug;5(4):347-9. doi: 10.1093/ckj/sfs050. Epub 2012 Jun 29.

DOI:10.1093/ckj/sfs050
PMID:25874095
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4393462/
Abstract

Pulmonary hypertension (PH) occurs in end-stage renal disease (ESRD) patients on long-term haemodialysis (HD) using an arterio-venous (A-V) access and can be attenuated by either kidney transplantation per se or surgical fistula ligation/revision. We report an exceptional case with severe PH after kidney transplantation due to ESRD and prior chronic intermittent HD via a patent A-V fistula. Gold-standard right heart catheterization findings have-for the first time-proven that following surgical shunt ligation of the A-V fistula, haemodynamics normalized completely in this patient.

摘要

肺动脉高压（PH）发生于接受长期血液透析（HD）并使用动静脉（A-V）通路的终末期肾病（ESRD）患者中，通过肾移植本身或手术结扎/修复瘘管可使其减轻。我们报告了一例特殊病例，该患者因ESRD和既往通过开放的A-V瘘进行慢性间歇性HD，在肾移植后出现严重PH。金标准右心导管检查结果首次证实，在对该患者的A-V瘘进行手术分流结扎后，其血流动力学完全恢复正常。

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本文引用的文献

1
[Pulmonary hypertension in end-stage renal disease: three case reports].[终末期肾病中的肺动脉高压：三例病例报告]
Dtsch Med Wochenschr. 2011 May;136(18):944-7. doi: 10.1055/s-0031-1275830. Epub 2011 Apr 27.
2
Updated clinical classification of pulmonary hypertension.肺动脉高压的更新临床分类。
J Am Coll Cardiol. 2009 Jun 30;54(1 Suppl):S43-S54. doi: 10.1016/j.jacc.2009.04.012.
3
The pathogenesis of pulmonary hypertension in haemodialysis patients via arterio-venous access.血液透析患者通过动静脉通路发生肺动脉高压的发病机制。
Nephrol Dial Transplant. 2005 Aug;20(8):1686-92. doi: 10.1093/ndt/gfh840. Epub 2005 Apr 19.
4
Arteriovenous fistula-associated high-output cardiac failure: a review of mechanisms.动静脉瘘相关的高输出量心力衰竭：机制综述
Am J Kidney Dis. 2004 May;43(5):e17-22. doi: 10.1053/j.ajkd.2004.01.016.
5
Pulmonary hypertension in patients with end-stage renal disease.终末期肾病患者的肺动脉高压
Chest. 2003 May;123(5):1577-82. doi: 10.1378/chest.123.5.1577.
6
Reversal of pulmonary hypertension after ligation of a brachiocephalic arteriovenous fistula.头臂动静脉瘘结扎术后肺动脉高压的逆转
Am J Kidney Dis. 2002 Sep;40(3):E8. doi: 10.1053/ajkd.2002.34932.