MESENTERIC ISCHEMIA IN HEMODIALYSIS-PATIE NTS

OBJECTIVES: Mesenteric ischemia is uncommon in the general population but is frequently encountered in chronic hemodialysis patients. We pre sent here four cases which occurred in our unit within one year while only six cases had been observed in the preceding twenty years. OBSERV ATIONS: Four chronic hemodialysis patients (age: 57 to 76 years) with renal failure due to diffuse atheromatous disease, presented non-occlu sive mesenteric ischemia. One patient died and one underwent resection of the colon. For the final two patients, prophylactic therapy was in itiated. DISCUSSION: Mesenteric ischemia is a severe condition which a ppears to occur more frequently in end-stage renal disease. In the chr onic hemodialysis patient excessive ultrafiltration or a too rapid fil tration rate can favor ischemia. Prophylactic measures must be taken a t the first sign of ischemia, especially since clinical and biological features of mesenteric ischemia remain largely non-specific.