Long-Term Peritoneal Dialysis in 2 Patients with Takayasu's Arteritis

Uchiyama, Kiyotaka; Kamijo, Yuka; Honda, Kazumasa; Yoshida, Ryochi; Yanagi, Mai; Nakatsuka, Mineo; Ishibashi, Yoshitaka

doi:10.3747/pdi.2016.00068

Cited by 1 publication

(1 citation statement)

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“…Although end-stage renal disease is one of the major complications of TA, hemodialysis induction can be difficult because of several factors including insufficient arterial flow for vascular access, which may cause distal ischemia and subclavian steal syndrome, difficulty in determining blood pressure, and hemodynamic instability during hemodialysis because of TA-associated cardiovascular complications. In the absence of vascular access, PD can be an optimal treatment strategy [9, 10]. A previous study reported the nearly complete preservation of the morphology of the peritoneal membrane, which might be expected because TA primarily affects large vessels, leading to relatively maintained peritoneal function [11].…”

Section: Discussionmentioning

confidence: 99%

Long-term peritoneal dialysis followed by kidney transplantation for Takayasu arteritis: a case report

2019

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Background Takayasu arteritis (TA) is a chronic vasculitis of unknown etiology that primarily affects large vessels. Although renal involvement is frequent in TA, patients with TA undergoing renal replacement therapy, especially long-term peritoneal dialysis (PD) and kidney transplantation (KTx), are rarely reported. We herein present the case of an elderly patient with TA treated by PD for more than 5 years and underwent KTx thereafter. Case presentation A 69-year-old female diagnosed with TA at the age of 19 was treated by PD for seven and a half years for end-stage renal disease due to TA. Dialysate-to-plasma ratio of creatinine, which was well maintained during this period, reflected the efficacy of long-term PD. However, her residual renal function declined; she developed malnutrition, inflammation, and atherosclerosis syndrome and underwent living-related KTx from her husband. Due to the total occlusion of the external iliac arteries with compensatory development of the internal iliac arteries, the right internal iliac artery was used as the anastomosis site. After KTx, the patient developed chronic active antibody-mediated rejection; however, the graft function was maintained throughout the follow-up period. Despite severe aortic calcification and intermittent claudication in the legs, her condition did not worsen, and the blood flow of the graft was preserved. Conclusions The current case illustrating the success of long-term PD and living-related KTx in maintaining kidney function in an elderly patient with TA is the first to demonstrate the potential of PD and KTx as feasible options for renal replacement therapy in TA accompanied by severe cardiac involvement.

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Section: Discussionmentioning

confidence: 99%