Hemodialysis reinitiation using a resurrected mummy fistula: a case report

Ziming Wan,Bo Tu,Qiquan Lai

doi:10.1186/s12882-018-1089-9

Abstract

BackgroundKidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation. We report a case of a patient who restarted hemodialysis after his second kidney graft failure using a long-discarded autologous arteriovenous fistula.Case presentationA 62-year-old man was diagnosed with end-stage renal disease 20 year ago, and a native arteriovenous fistula was created for hemodialysis. After the patient received his first kidney transplantation, the hemodialysis fistula was discarded and chronically thrombosed for 13 years. When the patient experienced his second kidney graft loss and presented with uremia again, dialysis restart was needed. Under vascular ultrasound, but not x-ray, guidance, we successfully revascularized the patient’s chronically occluded, long-discarded arteriovenous fistula access and used it for hemodialysis. The resurrected fistula remained patent and clinically useable for hemodialysis up to 18 months.ConclusionsThis report provides the feasibility of ultrasound-guided transluminal angioplasty for the treatment of a mummy hemodialysis fistula, which could be considered when managing patients who need dialysis reinitiation.

Highlights

Kidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation
This report provides the feasibility of ultrasound-guided transluminal angioplasty for the treatment of a mummy hemodialysis fistula, which could be considered when managing patients who need dialysis reinitiation
* Correspondence: bo.tu@dr.com 2Department of Ultrasonography, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing 400016, China Full list of author information is available at the end of the article instance, percutaneous transluminal angioplasty has been used to restore acutely or recently occluded hemodialysis fistulas, which was proved to be superior than open surgical intervention [7, 8]

Summary

Introduction

Kidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation. Conclusions: This report provides the feasibility of ultrasound-guided transluminal angioplasty for the treatment of a mummy hemodialysis fistula, which could be considered when managing patients who need dialysis reinitiation. The vascular access, which was created and used prior to kidney transplantation, has been discarded and chronically occluded when patients need re-start hemodialysis after graft loss.

Results

Conclusion