Aortic Aneurysm in Hemodialysis Patients: A Report of Two Cases

Abstract

Introduction: Aortic aneurysm (AA) is a frequent pathology in the general population. Patients at risk are those who have factors that can lead to arterial degeneration mainly high blood pressure (HBP), smoking and inflammation. In patients with chronic kidney failure (CKF) especially those who undergo hemodialysis who have almost all these risk factors, very little attention on the study of AA is accorded them. We reported two cases of AA in hemodialysis patients. Observation: Case 1. Fifty two (52) years old male, with past history of HBP since 21years of age, declared to have a terminal CKF from an undetermined nephropathy that has been on hemodialysis since 15 years. After 6 years of hemodialysis he presented an acute coronary syndrome associated with a painful abdominal syndrome which led to the diagnosis of aneurysm of the ascending aorta that measured 5cm in diameter. Therapeutic abstinence was adopted with annual follow up using chest angio-CT scan and thrombosis prevention using platelet aggregation inhibitors. The lesion is stable since 9 years. Case 2. Forty two (42) years old male, with no particular past history. Terminal CKF from an undetermined nephropathy that has been on hemodialysis since 6 years. On the 5 th year of hemodialysis he presented a painful abdominal syndrome with no gas no food passage that lead to the diagnosis of abdominal aorta aneurysm of 4.7cm diameter and a height of 12cm. Atherapeutic abstinence was adopted with follow up and anti thrombolytic therapy put. After one year of evolution, the patient developed a mesenteric artery ischemia that on exploration showed a fissuration of the aneurysm that lead to the death of the patient. Conclusion: Aortic aneurysm in CKF has been a concerned in patients who had in most cases polycystic kidney disease who were not yet on hemodialysis. AA is a reality in patients on hemodialysis. Its evolution is uncertain and at times it is fatal. Screening for it is obligatory.