Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China.
Department of Ultrasonography, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China.
BMC Nephrol. 2018 Oct 26;19(1):296. doi: 10.1186/s12882-018-1089-9.
Kidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation. We report a case of a patient who restarted hemodialysis after his second kidney graft failure using a long-discarded autologous arteriovenous fistula.
A 62-year-old man was diagnosed with end-stage renal disease 20 year ago, and a native arteriovenous fistula was created for hemodialysis. After the patient received his first kidney transplantation, the hemodialysis fistula was discarded and chronically thrombosed for 13 years. When the patient experienced his second kidney graft loss and presented with uremia again, dialysis restart was needed. Under vascular ultrasound, but not x-ray, guidance, we successfully revascularized the patient's chronically occluded, long-discarded arteriovenous fistula access and used it for hemodialysis. The resurrected fistula remained patent and clinically useable for hemodialysis up to 18 months.
This report provides the feasibility of ultrasound-guided transluminal angioplasty for the treatment of a mummy hemodialysis fistula, which could be considered when managing patients who need dialysis reinitiation.
肾移植失败会导致终末期肾病，需要重新开始透析。我们报告了 1 例患者，他在第 2 次肾移植失败后，重新使用废弃已久的自体动静脉瘘开始血液透析。
1 名 62 岁男性，20 年前被诊断为终末期肾病，曾建立自体动静脉瘘进行血液透析。患者接受第 1 次肾移植后，废弃了血液透析瘘管，13 年来瘘管一直处于慢性血栓形成状态。当患者第 2 次肾移植失败并再次出现尿毒症时，需要重新开始透析。在血管超声引导下（而非 X 射线引导下），我们成功地使患者长期闭塞、废弃已久的动静脉瘘再通，并将其用于血液透析。该再通的瘘管保持通畅，可用于血液透析长达 18 个月。
本报告提供了超声引导下经腔内血管成形术治疗木乃伊血液透析瘘的可行性，在需要重新开始透析的患者中，可以考虑采用这种方法。
