Presentation
Renal arteriovenous fistula (AVF) presents a rare but important condition that can be acquired, congenital, or idiopathic. [ncbi.nlm.nih.gov]
Discussion Renal AV fistula is an unusual presentation as discussed above. It is usually difficult to diagnose. Patients usually present with hypertension and hematuria [ 3 ]. [omicsonline.org]
Entire Body System
- Swelling
The swelling started two weeks after the operation and grew gradually over the course of two to three weeks. He did not complain of any pressure symptoms, nor was he experiencing pain distal to the swelling. [ijcasereportsandimages.com]
Your child will be asked to raise their arm and an ice pack may be applied to limit the swelling. The fistula will usually be rested until the swelling and bruising have improved. [gosh.nhs.uk]
Sometimes there is swelling or redness in the area where the graft is placed. The swelling will usually go away if you prop your arm on 1 or 2 pillows and keep your elbow straight and relaxed. [texasheart.org]
Symptoms If you have an AV fistula or AV graft malfunction, your doctor may notice symptoms when clinically examining the fistula or graft, such as a throbbing sensation in the area or swelling of the arm caused by fluid retention. [cirse.org]
The clinical presentation of urine leaks includes intense pain and swelling over or around the graft that radiates to surrounding areas, fevers, and change in graft function. [cjasn.asnjournals.org]
- Surgical Procedure
Vascular surgical procedures sparing renal parenchyma are relatively new, as the most common treatment for this condition had been nephrectomy. [ncbi.nlm.nih.gov]
Because of the enlargement and the multiplicity of the shunt vessels, a surgical procedure similar to the standard procedure for allogenic kidney transplantation was chosen with explantation of the kidney ( Figure 2 ). [academic.oup.com]
They are also widely known for being at the forefront of researching the best surgical techniques for this procedure. [yalemedicine.org]
For the surgical procedure, see Cimino fistula. "Arteriovenous shunt" redirects here. For nonpathologic AV shunts, see metarteriole and glomus body. [en.wikipedia.org]
- Renal Artery Stenosis
The most common etiologies of hypertension in neonates are renal artery thrombosis, renal artery stenosis, renal anomalies, coarctation of the aorta, and bronchopulmonary dysplasia. [accesspediatrics.mhmedical.com]
Transplant renal artery stenosis (TRAS). [cjasn.asnjournals.org]
Aortogram demonstrating the coexistence of a right renal arteriovenous fistula and moderate stenosis at the origin of the right renal artery. Fig. 2. [members.sirweb.org]
Doppler ultrasound is highly specific in cases of transplanted renal artery stenosis, pseudoaneurysms, arteriovenous fistulas, and thrombosis with complete or partial artery or vein occlusion. [ncbi.nlm.nih.gov]
Introduction In the evaluation of hypertension, an abdominal bruit normally suggests renal artery stenosis as the cause of the hypertension. [academic.oup.com]
- Gangrene
The Dialysis Outcomes and Practice Patterns (DOPPS) III reports that patients were less likely to use an AVF if they were female, of older age, had a greater body mass index or had diabetes, peripheral vascular disease or recurrent cellulitis/gangrene [advancedrenaleducation.com]
Benefits of an abridged antibiotic protocol for treatment of gangrenous appendicitis. J Pediatr Surg. 2014 Dec; 49(12):1723-5. PMID: 25487469. View in: PubMed Baird R, Puligandla PS, Laberge JM. [profiles.ucsf.edu]
Across three phases of data collection, patients consistently were less likely to use an AVF vs other VA types if female, of older age, having greater body mass index, diabetes, peripheral vascular disease or recurrent cellulitis/gangrene. [wjgnet.com]
Gastrointestinal
- Abdominal Pain
The patient's postoperative course was complicated by paradoxical hypertension and severe abdominal pain like that in the "post-coarctectomy syndrome." Satisfactory recovery has occurred and the patient remains normotensive. [ncbi.nlm.nih.gov]
Click here to view The most common symptom of renal AVF is hematuria; other clinical manifestations include hypertension, left ventricular hypertrophy, cardiac failure and abdominal pain. [13] Angiography is said to be the gold standard in the diagnosis [sjkdt.org]
Peritonitis can be recognized by cloudy dialysate outflow, fever, abdominal guarding (board-like abdomen), abdominal pain, pain on inflow, malaise, nausea, and vomiting. [quizlet.com]
pain which usually last Limitations of this study include its retrospective nature and small sample size. [journals.lww.com]
Hematuria is the major and most common symptom; other clinical manifestations, such as hypertension, left ventricular hypertrophy, cardiac failure, and abdominal pain are also usually associated with AVMs [ 2 ]. [jmedicalcasereports.biomedcentral.com]
- Severe Abdominal Pain
The patient's postoperative course was complicated by paradoxical hypertension and severe abdominal pain like that in the "post-coarctectomy syndrome." Satisfactory recovery has occurred and the patient remains normotensive. [ncbi.nlm.nih.gov]
Peritonitis can be recognized by cloudy dialysate outflow, fever, abdominal guarding (board-like abdomen), abdominal pain, pain on inflow, malaise, nausea, and vomiting. [quizlet.com]
Cardiovascular
- Hypertension
[…] for the hypertension associated with it. [ncbi.nlm.nih.gov]
- Heart Failure
Renal AVFs are often asymptomatic but are occasionally accompanied by hematuria or heart failure. Transcatheter closure with embolization is a safe and effective treatment for renal AVF. [ncbi.nlm.nih.gov]
- Vascular Disease
Although the indication for surgical treatment of renal vascular disease has decreased owing to the advancement of interventional techniques, there are still some risky cases for which surgical repair should be recommended. [ncbi.nlm.nih.gov]
Causes of Hypertension in Children Renal parenchymal disease Chronic pyelonephritis Cystic disease Glomerulonephritis Nephritis Reflux nephropathy Renal dysplasia Neoplasm Trauma Focal infarction Page kidney Renal vascular disease Coarctation of the aorta [accesspediatrics.mhmedical.com]
Renal Data System, USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2007 Dhingra [advancedrenaleducation.com]
Learn more » Vascular Surgery Offering comprehensive care of vascular disease through preventive services, diagnostic expertise, minimally invasive therapies and traditional surgical techniques. [surgery.usc.edu]
- Continuous Murmur
A continuous murmur and palpable thrill may be detected over the fistula and may be obliterated by compressing the feeding artery; this maneuver may slow the heartbeat (Branham's sign). [medical-dictionary.thefreedictionary.com]
"Asymptomatic spinal arteriovenous fistula presenting only as continuous murmur". Pediatr Int. 57 (6): 1208–10. doi : 10.1111/ped.12716. PMID 26711922. ↑ Leb DE, Sharma JK (July 1978). [wikidoc.org]
- Wide Pulse Pressure
The physical manifestations of this would be a relatively normal systolic blood pressure with a decreased diastolic blood pressure resulting in a wide pulse pressure. [en.wikipedia.org]
Urogenital
- Hematuria
The patient made an uneventful recovery with no further hematuria and progressive reduction of blood pressure. [ncbi.nlm.nih.gov]
- Kidney Failure
Chronic renal (kidney) failure— Progressive loss of kidney function over several years that can result in permanent kidney failure requiring dialysis. Electrolyte— Ions in the body that participate in metabolic reactions. [encyclopedia.com]
Many people who have kidney disease don't know it because the early signs can be very subtle. It can take many years to go from chronic kidney disease (CKD) to kidney failure. [mdcurrent.in]
It markets the System One directly to hospitals for treatment of acute kidney failure and fluid overload in the United States and other geographies. [reuters.com]
Overview When patients have chronic kidney disease or experience sudden kidney failure, there is a risk that their kidneys may permanently stop working. As a result, these patients will often receive haemodialysis several times a week. [cirse.org]
“For patients undergoing hemodialysis for kidney failure—who already spend a significant portion of their time undergoing dialysis and other treatments—repeated reinterventions to maintain AV access can be an added burden, with many patients returning [fiercebiotech.com]
- Macroscopic Hematuria
Two women visited our department complaining of sudden asymptomatic macroscopic hematuria. CT scans showed an irregular mass in the right kidney. Magnetic resonance angiography (MRA) revealed a cirsoid-type RAVF. [ncbi.nlm.nih.gov]
A 76-year-old woman visited our department complaining of sudden asymptomatic macroscopic hematuria. A CT scan showed an irregular mass (3 x 2 x 2 cm) in the right kidney. MRA revealed a cirsoid-type renal arteriovenous fistula. [semanticscholar.org]
CASE PRESENTATION A 40-year-old fit and healthy female presented to our tertiary referral center with a 3-day history of macroscopic hematuria and renal colic. [urotoday.com]
Macroscopic hematuria after biopsy occurs in 1%–7% of biopsies and is usually self-limiting ( 31 – 35 ). [cjasn.asnjournals.org]
Workup
If assessed to be at risk for rupture, a workup for associated access infection should be considered and a surgical consult for aneurysm repair initiated. Dual antiplatelet therapy should be avoided in patients with AV fistula aneurysms. [hindawi.com]
Treatment
Interventional embolization is currently the first line treatment for arteriovenous fistulas; however, the efficacy of repeated embolization remains controversial. [ncbi.nlm.nih.gov]
[…] or partial nephrectomy is considered as the last resort of treatment. [ijri.org]
Prognosis
The advanced therapeutic tools we used can improve the prognosis of patients with large and complicated arteriovenous fistulas and prevent surgery. [ncbi.nlm.nih.gov]
Treatment and prognosis Renal AVFs usually resolve spontaneously. It may be treated whenever it is symptomatic, large or extra-renal 1,4. The therapeutic method of choice is endovascular intervention. [radiopaedia.org]
Natural history and prognosis. Ann Surg 1983; 197 (3) 348-352 9 Ogawa S, Yanagida T, Kataoka M, et al. Laparoscopic nephrectomy, ex vivo angioplasty, and renal autotransplant for a renal artery aneuryms: A case report. [thieme-connect.com]
In AKI, other considerations include: Sodium >155 mmol/L or Severe acidosis (pH Severe renal failure – e.g. creatinine >500, urea >30 mmol/L Drug toxicity with drugs than can be dialysed Prognosis Prognosis in AKI is worse if oliguria is present. [almostadoctor.co.uk]
Elevated C-reactive protein in the diagnosis, prognosis, and cause of cancer. Crit Rev Clin Lab Sci. 2011;48(4):155–170. 24. Hogevik H, Olaison L, Andersson R, Alestig K. [dovepress.com]
Etiology
Etiology of Renal AV Fistula Congenital (25%): varicose-like multiple connections between artery and vein, most common at the upper pole of the kidney, female:male = 3:1 Renal trauma Iatrogenic causes: renal biopsy, kidney surgery Inflammatory etiology [urology-textbook.com]
This book serves these needs well through a nicely balanced focus on prevention, on the one hand, with its comprehensive review of epidemiology and etiology, and on management, on the other, with its practical comments on diagnosis, treatment and outcome [books.google.de]
Etiologies include congenital, trauma, malignancies, surgery and percutaneous kidney biopsies [ 1, 3 ]. Treatment and management include transcatheter coil embolization, surgical resection, or a combination of the two for definitive treatment [ 3 ]. [omicsonline.org]
The most common etiologies of hypertension in neonates are renal artery thrombosis, renal artery stenosis, renal anomalies, coarctation of the aorta, and bronchopulmonary dysplasia. [accesspediatrics.mhmedical.com]
It is known that inflammation due to other stimuli such as syphilitic infection of the aortic wall constitutes an etiology for the development of aortocaval fistulas [19]. [egms.de]
Epidemiology
The authors review relevant pathophysiological background and epidemiology, recommend necessary diagnostic testing, and provide detailed medical, surgical, and endourological management approaches. [books.google.de]
Epidemiology and outcome of infective endocarditis in hemodialysis patients. Am J Med Sci. 2002;324(5):254–260. 32. Rekik S, Trabelsi I, Hentati M, et al. [dovepress.com]
Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004;17:863-93. 21. [sjkdt.org]
Epidemiology Renal AVMs are uncommon. The estimated rate in large autopsy series is lower than 1 case per 30,000 patients. [emedicine.medscape.com]
Pathophysiology
The underlying pathophysiology was believed to be caused by the high-output state of pregnancy and by the increased peripheral vascular resistance of preeclampsia. [ncbi.nlm.nih.gov]
The authors review relevant pathophysiological background and epidemiology, recommend necessary diagnostic testing, and provide detailed medical, surgical, and endourological management approaches. [books.google.de]
Large A-V fistula: pathophysiological consequences and therapeutic perspectives. Curr Vasc Pharmacol. 2003 Oct;1(3):347-54. DOI: 10.2174/1570161033476619 10. Nagahara A, Nishimura K, Okuyama A. [egms.de]
In 1934, Goldblatt established the pathophysiology of renovascular hypertension, showing that reduction in total blood flow because of the occluding process and the loss of pulsatile character in the artery cause the juxtaglomerular apparatus to secrete [vasculardiseasemanagement.com]
[…] disease. [3] Predisposing factors include arteriosclerosis, fibromuscular dysplasia (FMD), congenital malformations of the kidney, renal angiomyolipoma, pregnancy and trauma. [4] Traumatic and iatrogenic renal artery pseudoaneurysms represent yet another pathophysiologic [sjkdt.org]
Prevention
The advanced therapeutic tools we used can improve the prognosis of patients with large and complicated arteriovenous fistulas and prevent surgery. [ncbi.nlm.nih.gov]
Even were it not for medical-legal liability, the importance of prompt recognition and correct treatment of injuries that we ourselves cause is obvious, as is the need for preventive measures to be clearly identified and adopted. [books.google.de]