Neurologic and ophthalmologic complications of vascular access in a hemodialysis patient.
Patients on long-term hemodialysis undergo multiple interventions, including insertion of central catheters and arteriovenous anastomoses for creation of vascular access. The need for high-flow vessels to maintain hemodialysis efficiency leads to wear on the central veins and consequent stenosis and occlusion. In addition to local signs of impaired venous drainage, abnormal venous flow patterns involving the upper chest, face, and central nervous system might develop. We describe the first pediatric case of devastating intracranial hypertension presenting with visual loss in the eye contralateral to a high-flow vascular access in a patient on long-term hemodialysis. The literature on this rare complication of hemodialysis is reviewed.
Cleper
Roxana
R
Department of Pediatric Nephrology, Schneider Children's Medical Center of Israel, Petah Tiqwa 49202, Israel. acleper@zahav.net.il
Goldenberg-Cohen
Nitza
N
Kornreich
Liora
L
Krause
Irit
I
Davidovits
Miriam
M
D000293:Adolescent; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006435:Renal Dialysis