Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Acute liver failure following hemodialysis arteriovenous graft placement: a case report. | Brener et al. Journal of Medical Case Reports 2010 4 261 http content 4 1 261 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Acute liver failure following hemodialysis arteriovenous graft placement a case report Zachary Z Brener1 Augusto D Paiusco1 Michael Bergman2 Abstract Introduction Severe high-output cardiac failure is a serious complication of high-flow vascular access requiring immediate intervention. Ischemic hepatitis is defined as a massive increase in serum transaminase levels due to an imbalance between hepatic oxygen supply and demand in the absence of other acute causes of liver damage. It is typically preceded by hypotension hypoxemia or both and occurs mostly in elderly patients with right-sided congestive heart failure. Case presentation We report a fatal case of acute liver failure in an 84-year-old Caucasian man with high-output cardiac failure due to arteriovenous hemodialysis access. The chronological sequence of acute liver failure in the context of vascular access created two days before suggests that ischemic hepatitis was the result of high-output cardiac failure due to vascular access. Conclusions A thorough cardiac assessment should be performed in patients with severe cardiac disease prior to placing an arteriovenous access and arteriovenous fistula should be the preferred vascular access. Introduction The chronic kidney disease CKD population generally has multiple risk factors and a high prevalence of cardiovascular disease. Thus it is easy to overlook the contribution of a high-access flow to symptoms of heart failure in favor of many other possible risk factors. Severe high-output cardiac failure is a rare but potentially fatal complication of high-flow vascular access requiring immediate intervention 1 2 . It is much more common with prosthetic grafts than with native arteriovenous fistulas AVF 3 . Ischemic hepatitis is an infrequent presentation usually associated with hypotension .
