Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases

Chun Yu Chen, Heng Jung Hsu, I. Wen Wu, Chiao Yin Sun, Chia Chi Chou, Chin Chan Lee, Mai-Szu Wu

Research output: Contribution to journalArticle

Abstract

Background: Mycotic aneurysms, which are infections of major vessels, have a high, morbidity and mortality, especially those located in the aorta. The pattern of vascular calcification is different in dialysis patients. We hypothesized that aortic mycotic aneurysm carried a different clinical course in dialysis patients.
Objectives: The purpose of this study was to observe whether the clinical course of aortic mycotic aneurysms in dialysis patients differs from that of the general population.
Methods: A total of 842 hemodialysis patients and 288 peritoneal dialysis patients entered the dialysis programs between January 2001 and December 2008. All patients were reviewed for aortic mycotic aneurysms; non-infectious aortic aneurysms were excluded. Three hemodialysis patients and one peritoneal dialysis patient were found to have aortic mycotic aneurysms. The demographic data, dialysis modalities, dialysis duration, initial presentation, co-morbidities, complete blood count, biochemistry data, microbiology survey, imaging studies, treatment, and clinical outcome in these patients were retrospectively reviewed.
Results: Four patients all received at least a 5-week antibiotic treatment course. None of the patients' aneurysms ruptured. Three patients who received only medical treatment all survived the acute phase, but they all died of cardiovascular events at a mean of 163.3±101.8 days from diagnosis. Only the patient who had surgery achieved long-term survival.
Conclusion: The present observational study indicated that aortic mycotic aneurysms are rare in dialysis patients. The spontaneous rupture rate is low, even with medical therapy alone. Surgical intervention may be associated with long-term survival. The results suggest that the clinical course of aortic mycotic aneurysm is different in uremic and non-uremic patients.
Original languageUndefined/Unknown
Pages (from-to)170-175
Number of pages6
JournalActa Nephrologica
Volume24
Issue number3
Publication statusPublished - 2010
Externally publishedYes

Keywords

  • 末期腎病
  • 感染性主動脈瘤
  • 血液透析
  • 血管硬化
  • 腹膜透析
  • End-stage renal disease
  • aorlic vnycotic aneurysm
  • hevnodiedysis
  • arteriosclerosis
  • continuous ambulatory peritoneal dialysis

Cite this

Chen, C. Y., Hsu, H. J., Wu, I. W., Sun, C. Y., Chou, C. C., Lee, C. C., & Wu, M-S. (2010). Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases. Acta Nephrologica, 24(3), 170-175.

Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases. / Chen, Chun Yu; Hsu, Heng Jung; Wu, I. Wen; Sun, Chiao Yin; Chou, Chia Chi; Lee, Chin Chan; Wu, Mai-Szu.

In: Acta Nephrologica, Vol. 24, No. 3, 2010, p. 170-175.

Research output: Contribution to journalArticle

Chen, CY, Hsu, HJ, Wu, IW, Sun, CY, Chou, CC, Lee, CC & Wu, M-S 2010, 'Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases', Acta Nephrologica, vol. 24, no. 3, pp. 170-175.
Chen CY, Hsu HJ, Wu IW, Sun CY, Chou CC, Lee CC et al. Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases. Acta Nephrologica. 2010;24(3):170-175.
Chen, Chun Yu ; Hsu, Heng Jung ; Wu, I. Wen ; Sun, Chiao Yin ; Chou, Chia Chi ; Lee, Chin Chan ; Wu, Mai-Szu. / Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases. In: Acta Nephrologica. 2010 ; Vol. 24, No. 3. pp. 170-175.
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title = "Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases",
abstract = "背景:在大動脈上的感染性動脈瘤是有著高死亡率和嚴重的病勢,尤其是在主動脈上的更是如此。由於在透析病人的血管壁的鈣化的方式與一般非透析病人的鈣化是不同的,因此感染性主動脈瘤的臨床病程是否有不同,仍然是未知的。目的:這研究的目的在於觀察透析病人的感染性主動脈瘤的臨床病程是否有別於文獻上所記載的非透析病人的臨床病程。方法:在本醫院的透析中心,從西元2001年l月至2008年12月共有842位病人接受規則血液透析及288位病人接受規則腹膜透。所有病人皆被回溯性的探討是否患有感染性主動脈瘤,而非感染性的主動脈瘤皆被排除。總共發現有三位血液透析病人及1位腹膜透析病人患有感染性主動脈瘤。這四位病人皆被回溯性的探討分析各種血液計數、生化、透析方法、透析時間、病程初次呈現、併發症、微生物學、影像學、治療過程及預後。結果:四位病人皆至少接受了5週的抗生素療程而沒有任何一位病人的動脈瘤破裂。其中三位接受單純內科治療的病人皆渡過這次急性感染期並存活,但是卻都在從診斷的平均1613±101.8天,死於心血管疾病。只有剩下的一位接受合併外科治療有長期存活。結論:目前的觀察性研究顯示,感染性主動脈瘤在透析病人是相當罕見的。儘管只接受內科治療,自發性破裂的機率是低的。外科治療可能與長期存活有關聯。這結果可能顯示,感染性主動脈瘤在透析病人的臨床病程有別於非透析病人。",
keywords = "末期腎病, 感染性主動脈瘤, 血液透析, 血管硬化, 腹膜透析, End-stage renal disease, aorlic vnycotic aneurysm, hevnodiedysis, arteriosclerosis, continuous ambulatory peritoneal dialysis",
author = "Chen, {Chun Yu} and Hsu, {Heng Jung} and Wu, {I. Wen} and Sun, {Chiao Yin} and Chou, {Chia Chi} and Lee, {Chin Chan} and Mai-Szu Wu",
year = "2010",
language = "未定义",
volume = "24",
pages = "170--175",
journal = "Acta Nephrologica",
issn = "1013-1671",
publisher = "社團法人台灣腎臟醫學會 & Airiti Press",
number = "3",

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TY - JOUR

T1 - Mycotic Aortic Aneurysms in Dialysis Patients: Analysis of Cases

AU - Chen, Chun Yu

AU - Hsu, Heng Jung

AU - Wu, I. Wen

AU - Sun, Chiao Yin

AU - Chou, Chia Chi

AU - Lee, Chin Chan

AU - Wu, Mai-Szu

PY - 2010

Y1 - 2010

N2 - 背景:在大動脈上的感染性動脈瘤是有著高死亡率和嚴重的病勢,尤其是在主動脈上的更是如此。由於在透析病人的血管壁的鈣化的方式與一般非透析病人的鈣化是不同的,因此感染性主動脈瘤的臨床病程是否有不同,仍然是未知的。目的:這研究的目的在於觀察透析病人的感染性主動脈瘤的臨床病程是否有別於文獻上所記載的非透析病人的臨床病程。方法:在本醫院的透析中心,從西元2001年l月至2008年12月共有842位病人接受規則血液透析及288位病人接受規則腹膜透。所有病人皆被回溯性的探討是否患有感染性主動脈瘤,而非感染性的主動脈瘤皆被排除。總共發現有三位血液透析病人及1位腹膜透析病人患有感染性主動脈瘤。這四位病人皆被回溯性的探討分析各種血液計數、生化、透析方法、透析時間、病程初次呈現、併發症、微生物學、影像學、治療過程及預後。結果:四位病人皆至少接受了5週的抗生素療程而沒有任何一位病人的動脈瘤破裂。其中三位接受單純內科治療的病人皆渡過這次急性感染期並存活,但是卻都在從診斷的平均1613±101.8天,死於心血管疾病。只有剩下的一位接受合併外科治療有長期存活。結論:目前的觀察性研究顯示,感染性主動脈瘤在透析病人是相當罕見的。儘管只接受內科治療,自發性破裂的機率是低的。外科治療可能與長期存活有關聯。這結果可能顯示,感染性主動脈瘤在透析病人的臨床病程有別於非透析病人。

AB - 背景:在大動脈上的感染性動脈瘤是有著高死亡率和嚴重的病勢,尤其是在主動脈上的更是如此。由於在透析病人的血管壁的鈣化的方式與一般非透析病人的鈣化是不同的,因此感染性主動脈瘤的臨床病程是否有不同,仍然是未知的。目的:這研究的目的在於觀察透析病人的感染性主動脈瘤的臨床病程是否有別於文獻上所記載的非透析病人的臨床病程。方法:在本醫院的透析中心,從西元2001年l月至2008年12月共有842位病人接受規則血液透析及288位病人接受規則腹膜透。所有病人皆被回溯性的探討是否患有感染性主動脈瘤,而非感染性的主動脈瘤皆被排除。總共發現有三位血液透析病人及1位腹膜透析病人患有感染性主動脈瘤。這四位病人皆被回溯性的探討分析各種血液計數、生化、透析方法、透析時間、病程初次呈現、併發症、微生物學、影像學、治療過程及預後。結果:四位病人皆至少接受了5週的抗生素療程而沒有任何一位病人的動脈瘤破裂。其中三位接受單純內科治療的病人皆渡過這次急性感染期並存活,但是卻都在從診斷的平均1613±101.8天,死於心血管疾病。只有剩下的一位接受合併外科治療有長期存活。結論:目前的觀察性研究顯示,感染性主動脈瘤在透析病人是相當罕見的。儘管只接受內科治療,自發性破裂的機率是低的。外科治療可能與長期存活有關聯。這結果可能顯示,感染性主動脈瘤在透析病人的臨床病程有別於非透析病人。

KW - 末期腎病

KW - 感染性主動脈瘤

KW - 血液透析

KW - 血管硬化

KW - 腹膜透析

KW - End-stage renal disease

KW - aorlic vnycotic aneurysm

KW - hevnodiedysis

KW - arteriosclerosis

KW - continuous ambulatory peritoneal dialysis

M3 - 文章

VL - 24

SP - 170

EP - 175

JO - Acta Nephrologica

JF - Acta Nephrologica

SN - 1013-1671

IS - 3

ER -