Aneurysm of aorta in hemodialysis: Two cases and literature review

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Sanee Ezzaki, I Failal, N Mtioui, S Elkhayat, G Medkouri, Zamd Benghanem and Ramdani B

CHU Ibn Rochd, Morocco

: J Nephrol Ren Dis

Abstract

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Introduction: Aortic Aneurysm (AA) is a common pathology in the general population. Subjects at risk are those with risk factors for arterial degeneration including arterial hypertension, smoking and inflammation. Although in chronic renal failure undergoing hemodialysis and especially these risk factors are almost all present, few studies devoted their AA. We report two cases of AA patients receiving hemodialysis.

Case-1: A man of 52 years old, antecedent of arterial hypertension for 21 years, reported chronic end-stage renal failure on indeterminate nephropathy in hemodialysis for 15 years. After 6 years of dialysis, it submitted an acute coronary syndrome accompanied by abdominal pain syndrome that led to the diagnosis of an aneurysm of the ascending aorta 5cm in diameter. No treatment was adopted with annual monitoring by CT angiography and preventing thrombosis by platelet antiaggregant. The lesion remains steady until 9 years.

Case-2: A man of 42 years old, with no particular history, reported chronic end-stage renal failure on indefinite nephropathy on hemodialysis for 6 years. At its 5th dialysis year he presented abdominal pain and inability to have a bowel movement or pass gas that led to the diagnosis of abdominal aortic aneurysm 4.7 cm in diameter and a height of 12 cm. No treatment was also adopted with surveillance and anti-thrombotic prevention. After 1 year of evolution, the patient had mesenteric ischemia syndrome exploration cracking of the aneurysm that led to his death.

Conclusion: AA at chronic kidney disease has been until a few case series that involved most often cases of polycystic kidney disease not yet on dialysis. AA patients receiving hemodialysis is a reality, evolution remains unpredictable sometimes fatal where screening is required.

Biography

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Sanae Ezzaki has completed her Graduation from the University of Medicine and Pharmacy of Rabat, Morocco. She is currently Resident in Nephrology Hemodialysis at the Ibn Rochd University and Hospital Center in Casablanca, Morocco.