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May 27, 1974

Aortic Dissection in a Patient With Chronic Hemodialysis

Author Affiliations

From the departments of medicine (Drs. Chiorazzi, Hetzel, Adler, and Wadler) and radiology (Dr. Stein), North Shore University Hospital, Manhasset, and Cornell University Medical College, New York.

JAMA. 1974;228(9):1146. doi:10.1001/jama.1974.03230340048032

DURING the relatively short history of hemodialysis, numerous complications have been recorded. Of these, vascular problems are the most common and life-threatening. This report describes aortic dissection in a chronic hemodialysis patient, a complication that has not yet been reported, to our knowledge.

Report of a Case  A 51-year-old woman was referred to North Shore University Hospital for treatment of chronic renal failure and maintenance hemodialysis. Her illness dated back ten years when labile hypertension was discovered, although no therapy was initiated. An evaluation at another institution five years later disclosed a substantial proteinuria (protein, 3.3 gm/24 hr) and uremia (blood urea nitrogen [BUN] level, 56 mg/100 ml; serum creatinine level, 4.4 mg/100 ml). A percutaneous renal biopsy specimen was consistent with chronic glomerulonephritis. The patient was treated effectively with dietary restriction, oral doses of hydralazine hydrochloride and digitalis until six months before referral when her condition rapidly deteriorated. Uremia