A Case of Conjunctival and Corneal Calcification in a Child on Peritoneal Dialysis

Calcification in patients with endstage renal disease on renal replacement therapy can occur in extraskeletal area such as conjunctiva and cornea. Conjunctival and corneal calcification (CCC) has mostly has been reported in adults with endstage renal disease on hemodialysis. CCC seems to be associated with the duration of renal replacement therapy, and high CaxP value. We report a 10-year-old girl who was on peritoneal dialysis for 31 months and presented with CCC on both eyes. Her corneal calcification was resolved after the epithelial debridement and ethylenediaminetetraacetic acid(EDTA) soaking therapy.

Brachio-basilic Arteriovenous Fistula Using Transposed Basilic Vein: An Alternative Vascular Access for Hemodialysis

PURPOSE: Effective hemodialysis for a patient with end-stage renal disease (ERDS) is dependent upon a durable, low-morbidity vascular access. Although It is generally agreed that the distal radiocephalic fistula originally discribed by Brescia and Cimino is the most effective primary access constrruction, no consensus exists regarding primary and secondary alternatives for patients with inadequate of failed rediocephalic prodedures. Many options are available, but the relative value of these alternative operations is unclear. Therefore the place of the basilic vein in secondary acccess construction needs to be assessed. We evaluated if the basilic vein can be used to construct a durable, low-morbidity access. METHODS: A native brachio-basilic arterio-venous fistula with superficial transposition has been performed, for lack of usuable vein on 54 forearm in 47 patients from August 1995 to October 1999 (Male: 15, female: 32) with mean age 51 years (26 to 70 years). RESULTS: The main cause of renal insufficiency were: diabetes 27 (57.4%), hypertensive 19 (40.4%), renal tuberculosis 2 (4.3%) and renal cyst 1 (2.1%). The waiting period before vascular access puncture has been 28 6 days. Eight (17.0%) stenosis has been detected and, forearm and/or hand edema occured in three (6.4%); thrombosis in two (4.3%); bleeding in two (4.3%); pseudoaneurysm in one. Through the follow-up periods of 50 months, the primary patency was 80.9% at 12 months and 78.7% at 24 months. CONCLUSION: The brachio-basilic fistula with superficial transposition of basilic vein is a valuable vascular access for diabetes, female old patients, and can remain an alternative method for even younger patients by avoiding the installation of artificial graft after failed forearm arteriovenous fistula.