Question

A 68-year-old male with chronic kidney disease underwent left brachiocephalic arteriovenous fistula 8 months back and is well functional. He complains of a feeling of coldness in left hand while undergoing dialysis for the past two months:
What is the condition he is suffering from?

Hint:

Steal syndrome is a common complication in patients with dialysis access. It can cause symptoms like coldness and pain in the distal limb, and management is necessary to restore proper circulation.

Answer 1

Step 1: Understanding the symptoms.
The patient has a functional arteriovenous (AV) fistula in his left arm for dialysis, and his complaint of coldness in the left hand is likely due to a vascular issue related to the AV fistula. The condition he is most likely suffering from is steal syndrome. Steal syndrome occurs when there is an excessive diversion of blood from the distal vascular bed (in this case, the hand) due to the increased flow through the AV fistula, leading to ischemia or a sensation of coldness and discomfort in the affected limb.

Step 2: Conclusion.
The patient is most likely suffering from dialysis access-related steal syndrome due to the arteriovenous fistula.