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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
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Exhausting multiple hemodialysis access failures.
Erjola Bolleke1, Saimir Seferi1, Merita Rroji1
1Nephrology and Dialysis Unit, UHC Mother Theresa, Tirana, Albania.
Medical Archives (Sarajevo, Bosnia and Herzegovina)
|January 9, 2015
Summary
Antiphospholipid antibody syndrome (APAS) can cause recurrent vascular access thrombosis in hemodialysis (HD) patients. Early detection and management of APAS are crucial for successful long-term vascular access in patients undergoing hemodialysis.
Area of Science:
- Nephrology
- Vascular Surgery
- Rheumatology
Background:
- Vascular access is critical for hemodialysis (HD) but prone to complications like thrombosis.
- Hypercoagulability states, such as Antiphospholipid Antibody Syndrome (APAS), can significantly complicate HD vascular access management.
Observation:
- A 41-year-old female with end-stage renal disease experienced recurrent vascular access failures due to thrombosis.
- Despite multiple interventions, her arteriovenous fistulas and grafts thrombosed, leaving limited access options.
- Thrombophilia screening revealed antiphospholipid antibodies, leading to an APAS diagnosis and warfarin anticoagulation.
Findings:
- Antiphospholipid antibody syndrome (APAS) was diagnosed in a patient with end-stage renal disease experiencing repeated vascular access thrombosis during hemodialysis.
- Anticoagulation with warfarin successfully maintained a single remaining arteriovenous graft for 18 months.
Implications:
- Nephrologists must consider APAS in hemodialysis patients with recurrent vascular access thrombosis.
- Prompt diagnosis and management of APAS are essential to prevent vascular access failure and ensure treatment continuity.
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