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
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Renal Artery Stenosis
Introduction In the evaluation of hypertension, an abdominal bruit normally suggests renal artery stenosis as the cause of the hypertension. [academic.oup.com]
In young children, the most common causes of hypertension are renal parenchymal disease, renal artery stenosis, and coarctation of the aorta. [accesspediatrics.mhmedical.com]
Transplant renal artery stenosis (TRAS). [cjasn.asnjournals.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]
Gastrointestinal
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Abdominal Bruit
A case is reported of a woman with long-standing progressive hypertension and an abdominal bruit who on angiography demonstrated fibromuscular dysplasia of the right renal artery and an arteriovenous fistula in the upper pole of the right kidney. [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]
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Right Flank Pain
A 50-year-old Japanese man presented with right flank pain and gross hematuria. The patient had undergone non-ischemic tumor enucleation for right renal cell carcinoma, 2 cm in diameter, 1 month previously. [ncbi.nlm.nih.gov]
Cardiovascular
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Heart Failure
Her symptoms and cardiovascular changes were consistent with congestive heart failure and severe preeclampsia. [ncbi.nlm.nih.gov]
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Vascular Disease
This case report describes the challenges in diagnosing PAN and highlights the importance of a holistic approach when encountering patients with multiple vascular diseases. [ncbi.nlm.nih.gov]
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]
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]
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Cardiomegaly
Her cardiomegaly was ameliorated, as manifested by a decrease in CTR to 57% and the absence of volume overload. [ncbi.nlm.nih.gov]
Further examination revealed a blood pressure of 206/110 mm. of Hg, cardiomegaly, with an... [mdedge.com]
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Decreased Diastolic Blood 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]
The physical manifestations of this would be a relatively normal systolic blood pressure with a decreased diastolic blood pressure resulting in a wide (large) pulse pressure. [wikidoc.org]
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Diastolic Hypertension
Increased renin secretion in this instance supports the proposed mechanism of diastolic hypertension with renal arteriovenous fistula. [ncbi.nlm.nih.gov]
Urogenital
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Nephrolithiasis
[…] between the artery and the vein. [9] We herewith report on a 20-year-old male patient who visited our hospital with complaints of hematuria (with clots) and abdominal pain one month after undergoing a percutaneous nephrolithotomy for the treatment of nephrolithiasis [sjkdt.org]
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Premature Ejaculation
Brand-new chapters and comprehensive updates throughout include new information on perioperative care in adults and children, premature ejaculation, retroperitoneal tumors, nocturia, and more! [books.google.de]
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]
Serum
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Hyperreninemia
The normal split function studies, renogram and renal vein renins do not support the concept of secondary hyperreninemia as a causative factor in the hypertension seen with renal arteriovenous fistulas. [ncbi.nlm.nih.gov]
Blocks
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Right Bundle Branch Block
The electrocardiogram recorded a right bundle branch block pattern (QRS 0.09 s) with a normal QRS axis and sinus bradycardia (HR 55 beat/min). Thoracic radiographs showed enlargement of the heart with widening of the right-outflow tract. [academic.oup.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]
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]
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]
Renal arteriovenous-fistulas - a review of etiology, diagnosis, and management. Surgery 1986 ; 99 : 114 –118. Rodgers MV, Moss AJ, Hoffman M, Lipchik EO. Arteriovenous fistulae secondary to renal cell carcinoma. [erj.ersjournals.com]
Epidemiology
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]
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]
PLoS One, 9(11), e110535. doi:10.1371/journal.pone.0110535 United States Renal Data System. (2016). 2016 USRDS annual data report: Epidemiology of kidney disease in the United States. [journals.lww.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]
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]
Hemodynamics and pathophysiology of arteriovenous fistulae. In: Rutherford RB, ed. Vascular Surgery. 5th ed. Philadelphia, PA: WB Saunders; 2000. Dickey KW, Pollak JS, Meier GH III, et al. [evtoday.com]
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]