A case report of 37-year-old female with end stage renal disease presented with recurrent pericardial effusion and cardiac tamponade, who underwent percutaneous balloon pericardiotomy using an Inoue balloon dilating catheter, to create a non-surgical pericardial window. The procedure of non-surgical pericardial window is safe and effective alternative to conventional more invasive surgical pericardial window. It is concluded that percutaneous balloon pericardiotomy is helpful in the management of massive pericardial effusions particularly in patients with chronic renal failure and poor clinical condition.
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The authors report the association of Kaposi's sarcoma with primary amyloidosis in a 54 yr old Jewish male. The diagnosis of primary amyloidosis was made in 1963 on a kidney and rectal biopsy. From that time, the patient developed chronic renal failure, and in 1965 uremic pericarditis and cardiac tamponade at the time of his transfer to a hospital for treatment by chronic hemodialysis. The day
... [Show full abstract] after a pleuropericardial window was made, the patient was started on chronic hemodialysis. After 5 yr of treatment, a 1.5 cm tumor was noted on the left leg. The patient died a few days after biopsies of the lesion of the leg and of a left inguinal node had shown Kaposi's sarcoma on the leg and chronic nonspecific adenitis. This is the first time that Kaposi's sarcoma has been reported in association with primary amyloidosis. Read more January 2001
We experienced the very rare complication of rotational atherectomy. A 40-year-old male on hemodialysis with angina and chronic renal failure underwent a coronary angiogram of the RCA that showed a 99% calcified ostial lesion and a very eccentric calcified 90% lesion at the mid location, At first, rotablation was successfully performed for the ostial lesion, and then we moved to the mid lesion
... [Show full abstract] and started rotablation. After the first passage through the lesion the burr became lodged, making it impossible to pull out, although the burr could still be rotated and antegrade flow was preserved. We crossed another guidewire and balloon catheter and dilated the lesion, but that failed to retrieve the burr because of a severe recoil phenomenon. Finally, we tried to pull the burr loose immediately after starting to deflate the balloon, resulting in successful dislodgement of the burr from the RCA. We concluded that this method should be tried if the burr cannot be retrieved and some space exists between the burr and the lesion. Read more May 1966 · Annals of Internal Medicine Read more January 1982
If standard arteriovenous vascular access is not available, alternatives must be created when hemodialysis is indicated. Most often the need is transient as in acute renal failure, or in chronic renal failure when a more permanent access has not yet matured. However, in an occasional patient all potential sites for permanent vascular access have become irreversibly occluded. In both acute and
... [Show full abstract] chronic failure, it may be of utmost importance to the child’s subsequent management to preserve as many peripheral vessel sites as possible for future fistula or shunt creation. A flexible catheter, percutaneously placed into an alternative vascular site, with sufficient caliber for adequate blood flow, and of variable length to accomodate to the child’s size would be of considerable value in these situations. Such a catheter has been developed for pediatrics in our unit with experience over a 22 month period in 21 children. Read more October 1968 · Circulation
Uremic pericarditis occurred in 41% of 83 patients admitted to the chronic dialysis program at the Peter Bent Brigham Hospital. In the vast majority of these patients the pericarditis was present before dialysis and cleared clinically after beginning therapy. Instances of pericarditis that developed during regular dialysis were associated with metabolic stress such as surgery or infection or
... [Show full abstract] inadequate dialysis. When the pericarditis failed to resolve the patients usually died with sepsis or had severe tamponade which necessitated early pericardiectomy. The two cases reported illustrate resorption of massive pericardial effusions with dialysis. The utility of percutaneous pericardial catheterization as a treatment for uremic pericardial tamponade is demonstrated. Read more September 2003 · Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion
Background. The prognosis and outcome in patients with end stage renal disease is significantly related to the predialysis care and early or late nephrological referral. Late nephrological referral has been associated with more hospital admissions and mortality at six months after the dialysis was initiated, We lack information about the role of early nephrological referral and its impact in
... [Show full abstract] biochemical variables and first hospitalization in our country. Methods. The charts of all patients that were admitted to peritoneal dialysis in the period 01/1999-06/2001 were reviewed. We divided the population in group A with patients referred to nephrologist more than 3 months before the start of dialysis (early referral) and group B with those patients referred for a period shorter than three months or no referred before the start of dialysis (late referral or no referral). The patient's characteristics, laboratory values, characteristics of the first hospitalization and drugs were analyzed when dialysis was initiated and after six months of follow-up. Results. Patients in group A were older and the percentage of patients with diabetes and hypertension was higher. The patients with early referral started dialysis with higher levels of hemoglobin (9.2 vs. 8.3 g/dL, p = 0.01) and with lower serum levels of BUN (91 vs. 122.5 mg/dL, p = 0.0001), creatinine (8.4 vs. 12.8 mg/dL, p = 0.0002) and phosphorus (6.4 vs. 7.7 mg/dL, p = 0.01). The length of the first hospitalization was shorter in patients of Group A (5.7 vs. 10.5 days, p = 0.004) and the emergency department was less used to peritoneal catheter placement in this group (46.3 vs. 86.9%, p = 0.01). There were not differences in hospitalization between the two groups after six months. Conclusion. Patients with early referral to a nephrologist show better biochemical variables, shorter first hospitalization length and higher percentage of elective placement of catheter. Read more January 1988 · Journal of Interventional Radiology
A 28-year-old hypertensive patient in chronic renal failure who was treated with ethanol ablation of her kidneys for severe hypertension developed an abscess in the left kidney. The abscess was drained percutaneously but subsequently recurred and the risk of further recurrence has prevented renal transplantation. There was no evidence of antecedent renal infection. Prophylactic antibiotic cover
... [Show full abstract] was not given prior to ethanol embolisation. Read more December 2003 · Journal of the Association for Vascular Access Read more January 1992 · West African journal of medicine
Symptomatic pericardial effusion (PE) occurred in two of our patients with chronic renal failure (CRF) who had taken minoxidil for control of their hypertension. One of them died from the effects of cardiogenic shock due to cardiac tamponade. The 2 patients had taken minoxidil for over 3 months. Other patients who had CRF had not developed symptomatic PE while being treated with other
... [Show full abstract] anti-hypertensive agents. Our experience conforms with reports from elsewhere that minoxidil may cause PE. Therefore, patients with CRF who need minoxidil as an anti-hypertensive agent should be examined regularly for clinical evidence of PE. Read more October 2010 · Kardiologia Polska
A case of a 58 year-old male with renal failure and recurrent cardiac tamponade is presented. In spite of extensive work-up, aetiology of pericardial effusion remained unknown. Diagnostic difficulties in this setting are discussed.
Read more July 2017
Tunneled cuffed catheters are inserted in patients with chronic renal failure expected to need dialysis for more than 2–3 weeks. This chapter describes indications, essential steps, variations, and complications of this procedure. It provides a detailed template operative note for the procedure.
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