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PERITONEAL DIALYSIS IN A PATIENT WITH RIGHT HEMIPARESIS, LUPUS NEPHRITIS, SIGNIFICANT INSUFFICIENCY OF ARTERIES OF AORTIC ARCH AND CELIAC DISEASE
KARMELA ALTABAS
; Klinika za unutarnje bolesti, KBC „Sestre milosrdnice“, Zagreb, Hrvatska
NATAŠA ČRNE
; Klinika za unutarnje bolesti, KBC „Sestre milosrdnice“, Zagreb, Hrvatska
BJÖRN DARIO FRANJIĆ
; Klinika za kirurgiju, KBC „Sestre milosrdnice“, Zagreb, Hrvatska
DRAŠKO PAVLOVIĆ
; Klinika za unutarnje bolesti, KBC „Sestre milosrdnice“, Zagreb, Hrvatska
JOSIPA JOSIPOVIĆ
; Klinika za unutarnje bolesti, KBC „Sestre milosrdnice“, Zagreb, Hrvatska
Sažetak
Peritoneal dialysis (Pd) is a method of choice in patients in whom there are difficulties concerning creation of av fistula. a 38-year old female patient came to our hospital because of a need of making an av fistula. she had end-stage renal insufficiency of unknown origin. she had a right hemiparesis with a contracture of the right fist and epilepsy because of the stroke she suffered in 1993. after doing the diagnostics, we have found that patient had lupus nephritis, occlusion of brachiocephalic trunk, right and left common carotid artery
and left subclavian artery. We also diagnosed celiac disease and a significant anemia. it was not possible to form an av fistula, as it was not possible to do an assisted Pd. because of the right hemiparesis and contracture of the right fist, the possibility of performing Pd
independently was questionable. despite the handicap, the patient had strong motivation and she managed to master the technique of Pd independently. even though it was estimated that she had a high risk score for applying anesthesia (asa iv), the insertion of the peritoneal
catheter went without complications. because of the comorbidity, especially because of the significant stenosis and occlusions of the arteries of aortic arch, the kidney transplantation will not be performed. in the last fifteen months, the patient is performing Pd independently, without any infectious complications, she is feeling well and is satisfied with the quality of her life. the consequences of the renal insufficiency are under control, systemic lupus erythematosus is, with a low dose of corticosteroids, in a steady state, malnutrition
is corrected, but there is still hypoalbuminemia noted.
Ključne riječi
peritoneal dialysis; lupus nephritis; chronic kidney disease; celiac disease
Hrčak ID:
99544
URI
Datum izdavanja:
3.4.2013.
Posjeta: 1.885 *