Abstract
Abstract Rationale: Cutis laxa is a rare disorder characterized by redundant, loose, and inelastic skin. Its chief histological feature is the reduction of elastic fibers in the dermal layer. Hypotension on dialysis is defined as a decrease in systolic blood pressure of ≥20 mm Hg or a decrease in mean arterial pressure of 10 mm Hg, accompanied by a clinical event requiring therapeutic intervention. Patient concerns: A 49-year-old female patient with cutis laxa who had frequent episodes of hypotension during hemodialysis. Diagnoses: A skin biopsy revealed changes typical of cutis laxa. Physical examination of the patient revealed systemic skin laxity with a presenile appearance. Interventions: We replaced conventional hemodialysis with hemodiafiltration. Outcomes: The hypotension improved after the patient started hemodiafiltration. Lessons: Cutis laxa may be a risk factor for hypotension during hemodialysis. Hemodiafiltration increases systemic vascular resistance and norepinephrine plasma levels in patients with cutis laxa, thereby stabilizing blood pressure. In a patient with cutis laxa, replacing conventional hemodialysis with hemodiafiltration resulted in an improvement in hypotension.
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