A 75-year man is
evaluated in the emergency department for nausea, vomiting, and weakness. He
has no history of kidney disease. BUN is 160 mg/dL, and serum creatinine is 13
mg/dL. Ultrasound examination reveals small kidneys without obstruction or
stones. You believe hemodialysis should be initiated promptly and expect the
patient to need chronic dialytic therapy. After discussing therapeutic options
with him, he concurs that chronic hemodialysis would best suit his needs. You
consult a vascular surgeon for placement of both temporary and permanent
angioaccess.
Which of the
following would be the optimal combination for this right-handed patient?
A. A left
forearm primary arteriovenous fistula and a right internal jugular tunneled
cuffed catheter
B. A right
forearm primary arteriovenous
fistula and right internal jugular tunneled cuffed catheter
C. A left
subclavian noncuffed catheter and a right forearm synthetic arteriovenous graft
D. A right
subclavian noncuffed catheter and a left forearm primary arteriovenous graft
kidney stone
ReplyDeleteKidney stone is a disease in the urinary tract wherein specks of minerals form into the urinary tract and even within the kidneys and as a result, it causes pain and discomfort.