Abstract
Son dönem böbrek yetersizliği (SDBY), kardiyovasküler morbidite ile yakından ilişkili yıkıcı bir hastalıktır. Kronik böbrek yetersizliği (KBY) tanılı hastalarının sağ kalım süresi arttığından, KBY ilişkili perikardiyal sendromların prevalansı artmaktadır. SDBY hastalarının perikardiyal tutulumu, yaygın olarak akut üremik perikardit veya diyaliz ilişkili perikardit ve seyrek olarak kronik konstriktif perikardit (KKP) olarak görülür. Bu olguda, böbrek greft kaybı sonrası hemodiyaliz tedavisi başlanan ve tedaviye uyum sağlamayan 17 yaşında erkek hastanın, göğüs ağrısı, nefes darlığı ile tarafımıza tekrarlayan başvuruları olan ve KKP tanısı alan olgu sunuldu. Tekrarlayan perikardiyal efüzyonu olan hastaya, yoğunlaştırılmış hemodiyaliz tedavisi uygulandı. Yoğunlaştırılmış diyaliz tedavisine yanıtı yeterli olmayan hastaya, KKP tanısı konuldu, total perikardiyektomi yapıldı. SDBY, KKP’nin nadir bir nedenidir, literatürde bildirilen vakaların çoğu yetişkin hastalarda tanımlanmış olup, pediatrik yaş grubunda çok nadirdir. Bu olgu, sağ kalp yetersizliği semptomları ile başvuran KBY hastalarının klinik değerlendirmesinde konstriktif perikardit açısından araştırılması gerektiğini vurgulamaktadır.
Supporting Institution
Yok
Project Number
Yok
Thanks
Yok
References
- 1. McDonald SP, Craig JC, Australian, New Zealand Paediatric Nephrology A. Long-term survival of children with end-stage renal disease. N Engl J Med 2004;350:2654-2662. google scholar
- 2. Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, et al. Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 2002;61:621-629. google scholar
- 3. Furth SL, Cole SR, Moxey-Mims M, Kaskel F, Mak R, Schwartz G, et al. Design and methods of the Chronic Kidney Disease in Children (CKiD) prospective cohort study. Clin J Am Soc Nephrol 2006;1:1006-1015. google scholar 4. Shroff R, Weaver DJ, Jr., Mitsnefes MM. Cardiovascular complications in children with chronic kidney disease. Nat Rev Nephrol 2011;7:642-649. google scholar
- 5. Alpert MA, Ravenscraft MD. Pericardial involvement in end-stage renal disease. Am J Med Sci 2003;325:228-236. google scholar
- 6. Strauss AW, Santa-Maria M, Goldring D. Constrictive pericarditis in children. Am J Dis Child 1975;129:822-826. google scholar
- 7. Major RW, Cheng MRI, Grant RA, Shantikumar S, Xu G, Oozeerally I, et al. Cardiovascular disease risk factors in chronic kidney disease: A systematic review and meta-analysis. PloS one 2018;13:e0192895. google scholar
- 8. Akhter MW, Nuno IN, Rahimtoola SH. Constrictive pericarditis masquerading as chronic idiopathic pleural effusion: importance of physical examination. Am J Med 2006;119:e1-4. google scholar
- 9. Dad T, Sarnak MJ. Pericarditis and Pericardial Effusions in End-Stage Renal Disease. Semin Dial 2016;29:366-373. google scholar
- 10. Sengupta PP, Eleid MF, Khandheria BK. Constrictive pericarditis. Circ J 2008;72:1555-1562. google scholar
- 11. Koshy SM, Hebert D, Lam K, Stukel TA, Guttmann A. Renal allograft loss during transition to adult healthcare services among pediatric renal transplant patients. Transplantation 2009;87:1733-1736. google scholar
- 12. Ferris M, Cohen S, Haberman C, Javalkar K, Massengill S, Mahan JD, et al. Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire. J Pediatr Nurs 2015;30:691-699. google scholar
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- 14. Chowdhury UK, Subramaniam GK, Kumar AS, Airan B, Singh R, Talwar S, et al. Pericardiectomy for constrictive pericarditis: a clinical, echocardiographic, and hemodynamic evaluation of two surgical techniques. Ann Thorac Surg 2006;81:522-529. google scholar
Abstract
End-stage renal disease (ESRD) is a devastating disease associated with cardiovascular morbidity. The prevalence of pericardial syndromes associated with ESRD is increasing because the survival of chronic renal failure (CRF) patients is prolonged. Pericardial involvement in ESRD is seen commonly as acute uremic or dialysis pericarditis and infrequently as chronic constrictive pericarditis (CCP). Here, we report on a 17-year-old male patient who started hemodialysis after kidney graft loss and did not comply with the treatment, and presented with recurrent chest pain, dyspnea, and hypotension. Sequential hemodialysis treatment was given to the patient, who had recurrent pericardial effusion. Despite frequent hemodialysis treatment, the patient’s response to treatment was not adequate. After diagnosis with CCP, total pericardiectomy was performed for definitive treatment. A literature review revealed end-stage kidney disease appears to be a relatively rare cause of CCP. Only a few other cases have been reported so far, mostly in adulthood. This case highlights that CRF patients presenting with symptoms of right heart failure should be investigated for constrictive pericarditis with clinical evaluations and examinations.
Project Number
Yok
References
- 1. McDonald SP, Craig JC, Australian, New Zealand Paediatric Nephrology A. Long-term survival of children with end-stage renal disease. N Engl J Med 2004;350:2654-2662. google scholar
- 2. Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, et al. Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 2002;61:621-629. google scholar
- 3. Furth SL, Cole SR, Moxey-Mims M, Kaskel F, Mak R, Schwartz G, et al. Design and methods of the Chronic Kidney Disease in Children (CKiD) prospective cohort study. Clin J Am Soc Nephrol 2006;1:1006-1015. google scholar 4. Shroff R, Weaver DJ, Jr., Mitsnefes MM. Cardiovascular complications in children with chronic kidney disease. Nat Rev Nephrol 2011;7:642-649. google scholar
- 5. Alpert MA, Ravenscraft MD. Pericardial involvement in end-stage renal disease. Am J Med Sci 2003;325:228-236. google scholar
- 6. Strauss AW, Santa-Maria M, Goldring D. Constrictive pericarditis in children. Am J Dis Child 1975;129:822-826. google scholar
- 7. Major RW, Cheng MRI, Grant RA, Shantikumar S, Xu G, Oozeerally I, et al. Cardiovascular disease risk factors in chronic kidney disease: A systematic review and meta-analysis. PloS one 2018;13:e0192895. google scholar
- 8. Akhter MW, Nuno IN, Rahimtoola SH. Constrictive pericarditis masquerading as chronic idiopathic pleural effusion: importance of physical examination. Am J Med 2006;119:e1-4. google scholar
- 9. Dad T, Sarnak MJ. Pericarditis and Pericardial Effusions in End-Stage Renal Disease. Semin Dial 2016;29:366-373. google scholar
- 10. Sengupta PP, Eleid MF, Khandheria BK. Constrictive pericarditis. Circ J 2008;72:1555-1562. google scholar
- 11. Koshy SM, Hebert D, Lam K, Stukel TA, Guttmann A. Renal allograft loss during transition to adult healthcare services among pediatric renal transplant patients. Transplantation 2009;87:1733-1736. google scholar
- 12. Ferris M, Cohen S, Haberman C, Javalkar K, Massengill S, Mahan JD, et al. Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire. J Pediatr Nurs 2015;30:691-699. google scholar
- 13. Talwar S, Nair VV, Choudhary SK, Sreeniwas V, Saxena A, Juneja R, et al. Pericardiectomy in children <15 years of age. Cardiol Young 2014;24:616-622. google scholar
- 14. Chowdhury UK, Subramaniam GK, Kumar AS, Airan B, Singh R, Talwar S, et al. Pericardiectomy for constrictive pericarditis: a clinical, echocardiographic, and hemodynamic evaluation of two surgical techniques. Ann Thorac Surg 2006;81:522-529. google scholar
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Paediatrics |
| Journal Section | Case Report |
| Authors | |
| Project Number | Yok |
| Publication Date | May 18, 2022 |
| Published in Issue | Year 2022 Volume: 22 Issue: 1 |
