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Bilateral dialysis-associated steal syndrome
Jeffrey D Kravetz1, Peter Heald
1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA. Jeffrey.Kravetz@med.va.gov <Jeffrey.Kravetz@med.va.gov>
Journal of the American Academy of Dermatology
|February 22, 2008
Summary
Dialysis-associated steal syndrome (DASS) is a rare complication of arteriovenous fistula creation. This case highlights bilateral DASS in an end-stage renal disease patient with a painful skin lesion, emphasizing the need for increased awareness.
Area of Science:
- Nephrology
- Vascular Surgery
- Clinical Case Reports
Background:
- Dialysis-associated steal syndrome (DASS) is an uncommon but serious complication following arteriovenous fistula (AVF) creation for hemodialysis access.
- The incidence of end-stage renal disease (ESRD) is increasing, suggesting a potential rise in DASS cases.
- Early recognition and management are crucial to prevent severe morbidity.
Observation:
- A unique case of a patient with end-stage renal disease (ESRD) presenting with a painful skin lesion is described.
- The patient subsequently developed bilateral dialysis-associated steal syndrome (DASS).
- This presentation is unusual, particularly the bilateral nature and association with a skin lesion.
Findings:
- The study details the clinical presentation and management of bilateral DASS in an ESRD patient.
- The findings underscore the potential for AVF complications to manifest in unexpected ways.
- The painful skin lesion preceded the development of bilateral DASS, suggesting a possible link or indicator.
Implications:
- Increased vigilance for DASS is warranted in ESRD patients, especially those with AVFs.
- This case highlights the importance of considering DASS in patients with concerning peripheral symptoms, even if seemingly unrelated.
- Further research may elucidate the pathophysiology and risk factors for bilateral DASS and its association with skin lesions.
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