Wednesday, May 16, 2018

Extracardiac Compression of Right Atrium by Hepatic Cysts in ADPKD



What is the impact of growing hepatic cysts in patient with polycystic kidney disease? We reported a rare complication - the cysts have caused extracardiac compression of right atrium resulting in impaired filling. Patient is at risk of refractory hypotension in the presence of significantly impaired right ventricular filling. Beside this, hepatic cysts burden has been reported to cause inferior vena cava compression, hepatic venous outflow obstruction and portal hypertension. Therapeutic options for symptomatic patients include cyst aspiration and sclerotherapy, cyst fenestration, transcatheter arterial embolization, or surgical intervention including cyst resection and liver transplantation.

Full Text:
KG Lee, SH Teo, H John, KWQ Guo, JL Kwek. Extracardiac compression of right atrium by hepatic cysts in a patient with polycystic kidney disease. Kidney International 2016; 90:230.

If you're interested in updates in ADPKD, a position statement by European ADPKD Forum can be read here.

Tuesday, May 15, 2018

Outcome of AVF Creation, Effects of Preop Vein Mapping and Predictors of Fistula Success in Incident Hemodialysis Patients


This single-centre study reported arteriovenous (AVF) outcomes of incident hemodialysis patients with 19,450 patient-month follow-up, successful AVF maturation was achieved in 78% with 1-year cumulative patency rate of 74%. Routine pre-operative vein mapping was not necessary if veins are suitable on physical examination for AVF creation.
KG Lee, TT Chong, N Goh et al. Outcomes of arteriovenous fistula creation, effect of preoperative vein mapping and predictors of fistula success in incident hemodialysis patients: A single-centre experience. Nephrology (Carlton) 2017; 22:382-7.
 

Tuesday, May 08, 2018

SCE Nephrology Exam Questions Writing


I am glad to be invited for authoring questions for SCE Nephrology Prep Course and all the questions were accepted. The guidance provided in authoring MCQs and replies from Editors are enlightening. Overall a good learning process!

Read more about the SCE Nephrology exam:

http://darrenmagic.blogspot.my/2012/04/sce-in-nephrology.html

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