ABSTRACT
Background: Arterio-venous fistula [AVF] provides the best functional patency for patients on regular hemodialysis [HD]. Nevertheless, complications such as AVF aneurysms, steal syndrome, venous hypertension and infections are not uncommon
Objective: To evaluate the trends in AVF aneurysm formations, prophylaxis and treatment options
Design: A Retrospective, Descriptive Study
Setting: Hemodialysis Centers, Ministry of Health, Kingdom of Bahrain
Method: Two hundred and eleven patients on hemodialysis via arterio-venous fistula and arteriovenous graft were included in the study
Result: Two hundred and eleven patients were on hemodialysis via arterio-venous fistula and arterio-venous graft. Thirty [14.22%] patients developed arterio-venous fistula aneurysm. Sixteen [53.33%] were males, and the mean age was 57 years. Eleven [36.66%] patients had excision of the aneurysms with interposition graft. Six [20%] patients had excision of the aneurysms with new fistula formation. Six [20%] patients required a change of the cannula insertion site while the remaining 7 [23.33%] patients were waiting for their scheduled date of surgery
Conclusion: Aneurysm formation is the most common complication in post AVF patients on regular HD. AVF aneurysms are at high risk of rupture and fatal hemorrhage. Surgical treatments could safely be performed for high risk aneurysms. The most common cause of aneurysm formation is repeated punctures at the same site
ABSTRACT
True posterior tibial artery aneurysm is an extremely rare pathology. A fifty-three-year-old Bahraini female presented with a pulsatile mass behind the left medial malleolus for one year duration. Arterial duplex and angiogram revealed a true saccular aneurysm of the posterior tibial artery. The aneurysm was resected and the posterior tibial artery was reconstructed with end-to-end anastomosis
Subject(s)
Humans , Female , Middle Aged , Tibial Arteries , Ultrasonography, Doppler, DuplexABSTRACT
hospital visits, has greater patient autonomy and could be adjusted to daily personal activities. However, complications such as peritonitis, line blockage, leakage and hernia, may occur. To evaluate the trends of Peritoneal Dialysis, its outcome and associated complications. A Retrospective, Descriptive Study. Peritoneal Dialysis Centers, Ministry of Health, Bahrain. One hundred eight patients who underwent peritoneal dialysis line insertion from January 2007 to January 2015 were included in this study. One hundred eight patients had peritoneal dialysis line insertion from January 2007 to January 2015. Forty-eight [44.44%] patients are currently on regular peritoneal dialysis. Sixty [55.55%] stopped peritoneal dialysis due to several reasons: 23 [38.3%] blockage, 11 [18.3%] death, 5 [8.3%] inadequate dialysis, 4 [6.6%] transplant, 4 [6.6%] social and 8 [13.3%] unknown. Complications occurred in 52 [48.1%] patients: peritonitis in 29 [26.8%], and blockage in 23 [21.3%] patients. No other complications were reported. Peritoneal Dialysis remains an effective method of renal replacement therapy and it offers several advantages in comparison to hemodialysis. Our results are consistent with most reported regional and international findings. However, we look forward to improve our practice, particularly reducing the infection and blockage rates
ABSTRACT
A forty-year-old Bahraini female with a known case of End Stage Renal Disease [ESRD] on Peritoneal Dialysis [PD] presented with a complaint of shortness of breath. She was found to have right side pleural effusion on a chest X-ray. The effusion was managed initially with Intercostal Drainage [ICD] insertion. The patient was investigated for the cause of the effusion and she was found to have hydrothorax secondary to pleuroperitoneal leak. She was initially treated with pleurodesis and temporary cessation of PD. However, this maneuver failed and the patient had to be shifted to hemodialysis as a permanent solution
Subject(s)
Humans , Female , Adult , Pleura , Peritoneum , Dyspnea , Kidney Failure, Chronic , PleurodesisABSTRACT
Vascular access surgery is needed for chronic renal failure patients who require regular hemodialysis to sustain their lives. Access surgery could be central line, graft fistula and native arteriovenous fistula [AVF], the latter has the best outcome in terms of least complication and durability. Therefore, hemodialysis through an AVF should be the main target in hemodialysis centers. To evaluate the trends of access surgery, its outcome and complication rate. A Retrospective Descriptive Study. Hemodialysis Centers, Ministry of Health, Kingdom of Bahrain. Three hundred six chronic renal failure patients were receiving regular hemodialysis until 15 May 2014 were included in the study. All the necessary data were collected through the Dialysis Access Nurse Coordinator. A specific modulated questionnaire was designed for this study. Three hundred six chronic renal failure patients are on regular hemodialysis until 15 May 2014. One hundred thirty-two [43.1%] were more than 60 years, and one hundred twenty-six [41.2%] were between 40 and 60 years. One hundred eighty-nine [61.8%] were receiving dialysis through AVF, eighty-five[27.7%]through central lines and thirty-two [10.5%] through graft fistulae. Fifty-seven [18.6%] patients were started on hemodialysis by fistula first. Twenty-eight [9.2%] patients had vascular access related complications; the most common was aneurysm. The trends and outcome of the hemodialysis access surgeries in the studied population are consistent with the Kidney Disease Outcome Quality Initiative [KDOQI] guidelines. The main complication was arteriovenous aneurysm formation
ABSTRACT
Diabetic foot adds significant morbidity and mortality to patients. Diabetic patients with foot complication require significant foot care and have a risk of limb amputation. The risk factors are controllable and can be prevented with careful blood glycemic control. To determine the risk factors and personal characteristics of diabetic foot patients and their impact on the socioeconomic status in Bahrain. A Prospective descriptive study. Vascular and Thoracic unit, Salmaniya Medical Complex, Bahrain. Eighty-seven patients with diabetic foot were admitted in the Vascular and Thoracic surgery service from March to June 2010. Seventeen [20%] were non-Bahraini. The majority of diabetic foot patients were male, 60 [69%]. Sixty-eight [78%] were diagnosed as first presentation of diabetic foot. Fifty-eight [66.5%] were 40-60 years old. Sixty [69%] were diagnosed with neuropathic foot. Thirty-five [40%] patients were diagnosed with diabetes mellitus for 10 years or less. Sixty-one [70%] patients had HbA1c more than 7. Twenty-two [25%] patients had amputation as a primary treatment. Seventeen [19.5%] patients required minor amputation and 5 [5.5%] patients had major amputation. The majority of patients with diabetic foot in Bahrain are males in the productive age group. A significant number of these patients undergo amputation as a primary treatment; these patients are increasing the socioeconomic burden to the health services in Bahrain as well as to the community