Complex condition of coronary artery disease in chronic kidney disease. Case report

  • Nayely García Méndez Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile
  • Othniel Cortés Molina Centro Médico Nacional La Raza, Hospital General Dr. Gaudencio González Garza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
  • Ramón Campos-Durán Centro Médico Nacional La Raza, Hospital General Dr. Gaudencio González Garza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
  • José Luis Ponce Hernández Centro Médico Nacional La Raza, Hospital General Dr. Gaudencio González Garza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
  • Guillermo Careaga Reyna Centro Médico Nacional La Raza, Hospital General Dr. Gaudencio González Garza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
  • Carlos Manterol Centro de Excelencia en Estudios Morfológicos y Quirúrgicos (CEMyQ), Universidad de La Frontera, Temuco, Chile
Keywords: cardiovascular disease, chronic kidney disease, percutaneous coronary intervention, hemodynamics, anesthesia

Abstract

Introduction: Patients with chronic kidney disease are at high risk of developing cardiomyopathy, atherosclerosis and arteriosclerosis. Atherosclerosis is the main cause of ischemic heart disease in CKD patients in substitute therapy such as dialysis (hemodialysis or peritoneal dialysis) and transplantation. In the case of dialysis, cardiovascular diseases increase the risk of arrhythmias and sudden cardiac death. Objectives: To provide a number of perioperative considerations to be taken into account during hemodynamic management of the chronic kidney disease patient by the multidisciplinary team involved in patient care with chronic kidney disease. Clinical case: We present a 52-year-old male patient with the following cardiovascular risk factors: age, sedentary lifestyle, hypertension, DMT2, CKD 5D KDIGO stage, congestive heart failure, New York Heart Association (NYHA) 2 and history of percutaneous coronary intervention (PCI) due to acute coronary syndrome, 5 years ago, in renal transplant protocol. The patient was successfully subjected to emergency PCI and during the endovascular procedure, a medicated balloon was placed. A In.Pact falcon™ DCB 3 x 20 mm intra stent to the prior DA and direct resolute onyx ™ DES 3.0 x 38 mm stent to the proximal segment of the circumflex artery. Conclusions: In this clinical case, coronary intervention was carried out successfully. The patient's evolution was favorable due to follow-up by multidisciplinary team made up of nephrologists, hemodynamic specialist, cardiologists, intensive care doctors and anesthesiologists who participated in the Infarction Code group.

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Published
2021-12-06
How to Cite
1.
García Méndez N, Cortés Molina O, Campos-Durán R, Ponce Hernández JL, Careaga Reyna G, Manterol C. Complex condition of coronary artery disease in chronic kidney disease. Case report. Rev Nefrol Dial Traspl. [Internet]. 2021Dec.6 [cited 2024Oct.6];41(4):285-91. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/719
Issue
Vol. 41 No. 4 (2021): Oct. - Dic.
Section
Case Report

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