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Hajji M, Harzallah A, Kaaroud H, Jerbi M, Chargui S, Younsi FE, Hamida FB, Abdallah TB. [Exhaustion of vascular capital in patients on hemodialysis: what will be the outcome?]. Pan Afr Med J 2017; 25:237. [PMID: 28293353 PMCID: PMC5337301 DOI: 10.11604/pamj.2016.25.237.10665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/02/2016] [Indexed: 11/11/2022] Open
Abstract
Despite advances in the treatment of chronic renal failure, vascular access remains the weakest link in renal replacement therapy (RRT) and the leading cause of morbidity in patients on hemodialysis We report the case of a young female patient with chronic renal insufficiency secondary to vascular nephropathy on periodic hemodialysis and whose vascular capital was early exhausted due to iterative thromboses in arteriovenous fistulas and failure in peritoneal dialysis. Protein C deficiency was objectified. The patient underwent tunneled hemodialysis catheter insertion at the level of the right atrium via a right anterolateral thoracotomy with cannulation of the inferior vena cava, with poor functional outcome after three months of use. Since then she has been dialyzed using puncture of the external jugular veins.
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Affiliation(s)
- Meriam Hajji
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Amel Harzallah
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Hayet Kaaroud
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Mona Jerbi
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Soumaya Chargui
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Fethi El Younsi
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Fethi Ben Hamida
- Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie; Faculté de Médecine de Tunis, université Tunis El Manar, Tunis, Tunisie
| | - Taieb Ben Abdallah
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie; Laboratoire de Pathologie Rénale LR00SP01, Hôpital Charles Nicolle, Tunis, Tunisie
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