How serious can renal arteriovenous fistula be?

summary

A good friend of mine told me that he might ask for a month's leave during this period of time. I asked him what was the matter. They said that they had a rare disease called renal arteriovenous fistula, which is really unheard of. How can renal arteriovenous fistula be differentiated and diagnosed? What complications can it cause?

How serious can renal arteriovenous fistula be?

Renal arteriovenous fistula may have local and systemic manifestations according to its size. Vascular murmur can be heard in clinic, and the blood perfusion of renal parenchyma is relatively reduced, resulting in distal ischemia and renin dependent hypertension. On the other hand, due to the increase of venous return, the peripheral resistance decreases and the cardiac output increases, which leads to left ventricular hypertrophy and eventually leads to heart failure. Because arteriovenous fistulas are often located near the collection system, gross hematuria can occur in about 75% of patients.

Heart enlargement and heart failure, due to a large amount of blood through the fistula hole quickly into the vein, venous pressure increases, the heart's return blood volume increases, causing heart enlargement. Progressive enlargement of the heart can lead to heart failure. The degree of heart enlargement and heart failure is closely related to the size, location and duration of fistula. The closer the fistula to the heart, such as the arteriovenous fistula formed by the direct branches of the aortic arch (carotid artery, innominate artery, subclavian artery) and the accompanying vein, the earlier and more severe the heart failure.

What diseases can renal arteriovenous fistula cause? Local warming, skin temperature of affected limb on the surface of arteriovenous fistula increased, high flow rate, skin temperature of distal part of arteriovenous fistula may be normal or lower than normal. Venous insufficiency, direct communication between the artery and vein, make venous pressure increased. In most patients, superficial varices were found near or far from arteriovenous fistula. Skin pigmentation, toes or fingers often ulcer, performance similar to deep vein thrombosis symptoms. Distal limb ischemia is more common in arteriovenous fistulas with high flow shunt, and the decrease of blood supply in distal limb leads to ischemia like signs.

matters needing attention

prevention. The diet should be high quality, low protein, high vitamin, low salt and low potassium food; High quality protein diet means that about 50% - 60% of them must be protein rich in essential amino acids (i.e. high biological value and high quality protein), such as eggs, fish, lean meat and milk. We should eat less food rich in plant protein, such as peanut and its products, because it contains more non essential amino acids. In order to limit the intake of plant protein, wheat starch (clear flour) can be used as staple food instead of rice and flour. The determination of serum albumin, albumin precursor and transferrin is a simple monitoring index. Some leeks, scallions, tofu, walnuts, peanuts and oysters are good for the kidney.