Son Dönem Böbrek Yetersizliğinin Nadir Bir Komplikasyonu: Konstriktif Perikardit

Yıl 2022, , 67 - 70, 18.05.2022

Cansu Ceren Eryılmaz , Özlem Çam Damla Akbulut Zeynep Yuruk Yildirim , Bağdagül Aksu Alev Yılmaz , Kemal Nişli , Ahmet Nayır

https://doi.org/10.26650/jchild.2022.822910

Öz

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.

Anahtar Kelimeler

Perikardiyektomi, renal replasman tedavileri, renal greft, kardiyovasküler

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

A Rare Complication of End-stage Renal Disease: Constrictive Pericarditis

Öz

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.

Anahtar Kelimeler

Pericardiectomy, renal replacement treatment, renal graft, cardiovascular

Proje Numarası

Yok

Kaynakça

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