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Cramps during hemodialysis : are they always innocent ?
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Journal Article
Cramps during hemodialysis : are they always innocent ?
2019
Overview
Cramps are very common in hemodialysis (HD) patients. A high ultrafiltration rate
and volume contraction have been implicated in the pathogenesis, but the underlying mechanism
is not yet fully elucidated. We present a male HD patient with cramps during his session,
attributed to acute limb ischemia due to thrombosis of a common femoral artery aneurysm
(CFAA). The true CFAAs are extremely rare, but the pseudoaneurysms (or false aneurysms) are
less uncommon resulting after femoral catheterization for diagnostic and therapeutic procedures.
This aneurysm was eccentric in shape which in conjunction with the patient’s history of femoral
catheterization strongly suggests us to consider it a pseudoaneurysm. Although the patient was
operated with the clinical suspicion of arterial embolism due to atrial fibrillation and the
subtherapeutic anticoagulation, no embolus was found in the aneurysm. We want to emphasize
that the presence of cramps is not always innocent, simply attributed to HD. Rarely, it may result
from or mask severe and devastating acute leg ischemia caused by thrombosis of a CFAA.
Notably, the thrombosis of a CFAA (true or false) is an extremely rare condition. We suggest all
the HD patients with a history of femoral cannulation to undergo a vascular ultrasound in the
related femoral artery at least once, to manage and to prevent the complications.
Publisher
Saudi Center for Organ Transplantation,Wolters Kluwer India Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,Wolters Kluwer Medknow Publications
Subject
/ Aneurysm, False - diagnostic imaging
/ Blood Vessel Prosthesis Implantation
/ Catheterization, Peripheral - adverse effects
/ Femoral Artery - diagnostic imaging
/ Humans
/ Ischemia
/ Ischemia - diagnostic imaging
/ Lower Extremity - blood supply
/ Male
/ Patients
/ Renal Dialysis - adverse effects
/ Sodium
/ Thrombosis - diagnostic imaging
/ Vascular System Injuries - diagnostic imaging
/ Vascular System Injuries - etiology
/ Vascular System Injuries - surgery
/ الأمراض
/ التشنجات
/ الكلى
/ المرضى
