Idiopathic right common iliac artery aneurysm in a three-year-old child - case report

The incidence of iliac aneurysms in children is unknown and there are only a small number of case reports in the literature on the subject. This article describes the case of a 3-year-old male patient with an isolated saccular aneurysm at the bifurcation of the right common iliac artery, of idiopathic origin, which was repaired by resection, ligature of the internal iliac artery and end-to-end vascular anastomosis. After 1 month of follow-up, he was diagnosed with asymptomatic occlusion of the anastomosis. The occlusion had no clinical repercussions because of collateral circulation and the child has had a favorable clinical course over the medium term.

Analysis of economic impact between the modality of renal replacement therapy

INTRODUCTION

Chronic kidney disease (CKD) is a major health problem, determining the reduction in life expectancy and an increased risk of cardiovascular disease.

METHOD

An observational, cohort, retrospective, based on patient's medical records data with CKD under hemodialysis, peritoneal dialysis and kidney transplantation in the city of Curitiba, in the period from January to June 2014, evacuativo the financial impact on the Unified Health System (SUS) and the supplementary health.

RESULTS

The lowest cost of a kidney transplant in the first year was R$ 40,743.03 when cyclosporine was used and the highest was R$ 48,388.17 with the use of tacrolimus. In the second year post-transplant, hemodialysis and peritoneal dialysis have a higher cost compared to kidney transplant. Transplantation with deceased donor, treated with tacrolimus: R$ 67,023.39; Hemodialysis R$ 71,717.51 and automated peritoneal dialysis automatic R$ 69,527.03.

CONCLUSIONS

After the first two years of renal replacement therapy, transplantation demonstrates lower costs to the system when compared to other modalities evaluated. Based on that, this therapy justifies improvements in government policies in this sector.

Pelvic kidney for living transplantation: case report and review of the literature

INTRODUCTION

The difference between available kidneys and the number of patients on waiting list for kidney transplantation continues to grow. For this reason the trend is to use donors with expanded criteria, such as a pelvic kidney, as we describe below.

CASE REPORT

Male patient 25 years-old with end-stage kidney disease, receives as a graft a pelvic kidney from his father, 49 years-old, known to have controlled systemic arterial hypertension and nephrolithiasis by history without new episodes in the last 10 years. Function and anatomy of the pelvic kidney were evaluated through magnetic angioressonance, computerized tomography and scintigraphy. After an initial rejection episode promptly treated, the patient has had an uneventful recovery.

CONCLUSION

To increase the number of kidneys available for transplantation, it is reasonable to use a pelvic kidney, after a thorough investigation.