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Abstract

Purpose

The aim of this work was to increase recognition of high flow arteriovenous fistulas in kidney transplant patients.

Case

Here, we report the case of a 22-year-old man with repeated hospitalizations for cardiomegaly and chronic pericardial effusion after kidney transplantation. Eventually, high flow of his arteriovenous fistula was recognized 5.5 years after transplantation when he developed acute cardiorenal syndrome. Access flow reduction markedly improved kidney graft function along with reversion of cardiomegaly, which was impressively demonstrated by follow-up chest-x-rays.

Conclusion

Arteriovenous fistulas should be monitored regularly after kidney transplantation to avoid congestive heart failure and other serious complications.

Keywords

Cardiorenal syndrome High flow fistula Kidney transplantation

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References

MacRae

J.M.

, Pandeya

, Humen

D.P.

, Krivitski

, Lindsay

R.M.

Arteriovenous fistula-associated high-output cardiac failure: a review of mechanisms.

Am J Kidney Dis. 2004; 43(5): e17–e22.

National Kidney Foundation Kidney Disease Outcomes and Quality Initiative (K/DOQI). 2006 update. National Kidney Foundation, Inc., 2006. Available at www.kidney.org.

Manca

, Pisano

G.L.

, Carta

The management of hemodialysis arteriovenous fistulas in well functioning renal transplanted patients: many doubts, few certainties.

J Vasc Access. 2005; 6(4): 182–186.

Lentine

K.L.

, Schnitzler

M.A.

, Abbott

K.C.

De Novo Congestive Heart Failure After Kidney Transplantation: A Common Condition With Poor Prognostic Implications.

Am J Kidney Dis. 2005; 46(4): 720–733.

Young

Jr. , Rohr

M.S.

, Marterre

W.F.

Jr. . High-output cardiac failure secondary to a brachiocephalic arteriovenous hemodialysis fistula: two cases. Am Surg. 1998; 64(3): 239–241.

Engelberts

, Tordoir

J.H.

, Boon

E.S.

, Schreij

High-output cardiac failure due to excessive shunting in a hemodialysis access fistula: an easily overlooked diagnosis.

Am J Nephrol. 1995; 15(4): 323–326.

Isoda

, Kajiwara

, Kondo

, Matsumoto

Banding a hemodialysis arteriovenous fistula to decrease blood flow and resolve high output cardiac failure: report of a case.

Surg Today. 1994; 24(8): 734–736.

Anderson

C.B.

, Codd

J.R.

, Graff

R.A.

, Groce

M.A.

, Harter

H.R.

, Newton

W.T.

Cardiac failure and upper extremity arteriovenous dialysis fistulas. Case reports and a review of the literature.

Arch Intern Med. 1976; 136(3): 292–297.

Unger

, Wissing

K.M.

, de Pauw

, Neubauer

, van de Borne

Reduction of left ventricular diameter and mass after surgical arteriovenous fistula closure in renal transplant recipients.

Transplantation. 2002; 74(1): 73–79.

10.

Movilli

, Viola

B.F.

, Brunori

Long-term effects of arteriovenous fistula closure on echocardiographic functional and structural findings in hemodialysis patients: a prospective study.

Am J Kidney Dis. 2010; 55(4): 682–689.

11.

Unger

, Xhaët

, Wissing

K.M.

, Najem

, Dehon

, van de Borne

Arteriovenous fistula closure after renal transplantation: a prospective study with 24-hour ambulatory blood pressure monitoring.

Transplantation. 2008; 85(3): 482–485.

12.

Basile

, Lomonte

, Vernaglione

, Casucci

, Antonelli

, Losurdo

The relationship between the flow of arteriovenous fistula and cardiac output in haemodialysis patients.

Nephrol Dial Transplant. 2008; 23(1): 282–287.

13.

Miller

G.A.

, Goel

, Friedman

The MILLER banding procedure is an effective method for treating dialysis-associated steal syndrome.

Kidney Int. 2010; 77(4): 359–366.

Acute Cardiorenal Syndrome by High Flow Arteriovenous Fistula after Kidney Transplantation