• Boris Zingerman, Yaacov Ori, Asher Korzets, Michal Herman-Edelstein, Netta Lev, Benaya Rozen-Zvi, and Eli Atar.
• Department of Nephrology and Hypertension, Rabin Medical Center (Hasharon Campus), Petah Tikva, Israel.
• Isr Med Assoc J. 2021 Sep 1; 23 (9): 590-594.

BackgroundAmong dialysis patients, occlusive mesenteric vascular disease has rarely been reported.ObjectivesTo report on the experience of one center with regard to diagnosing and treating this complication.MethodsThe retrospective case-series involved six patients (3 females, 3 males; age 52-88 years; 5/6 were smokers) on chronic hemodialysis at a single center. All patients with symptoms suggestive of occlusive mesenteric disease and a subsequent angiographic intervention were included. Demographic, clinical, and laboratory data were collected from patient charts for the period before and after angioplasty and stenting of the mesenteric vessels. A Wilcoxon signed-rank test was used to compare the relevant data before and after the intervention.ResultsAll participants had variable co-morbidities and postprandial abdominal pain, food aversion, and weight loss. CT angiography was limited due to heavy vascular calcifications. All underwent angioplasty with stenting of the superior mesenteric artery (4 patients) or the celiac artery (2 patients). All procedures were successful in resolving abdominal pain, malnutrition, and inflammation. Weight loss before was 15 ± 2 kg and weight gain after was 6 ± 2 kg. C-reactive protein decreased from 13.4 ± 5.2 mg/dl to 2.2 ± 0.4 mg/dl (P < 0.05). Serum albumin increased from 3.0 ± 0.2 g/dl to 3.9 ± 0.1 g/dl (P < 0.05). Two patients underwent a repeat procedure (4 years, 5 months, respectively). Follow-up ranged from 0.5-7 years.ConclusionsOcclusive mesenteric ischemia occurs among dialysis patients. The diagnosis requires a high degree of suspicion, and it is manageable by angiography and stenting of the most involved mesenteric artery.

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