The Association of Venotonic Agents in Decreasing Post-Operative Edema Chronic Kidney Disease

A Resident Doctor in the Department of Surgery specifically in Thoracic and Cardiovascular Surgery, Dra. Dana Rosielou Rubiano has an ongoing research entitled “The Association of Venotonic Agents in Decreasing Post-Operative Edema Chronic Kidney Disease Patients with a Permanent Hemodialysis Access: A retrospective study”. Her study aims to determine the effect of venotonic agents in reducing postoperative venous hypertension thus decreasing upper extremity edema in patients with chronic kidney disease who underwent permanent access creation. The amount allotted for her research was Php 10,000.00.

Chronic Kidney Disease is a chronic debilitating disease that occurs due to progressive loss of kidney function. Arteriovenous fistulas are the lifeline of these dialysis patients. The Kidney Disease Outcomes Quality Initiative (KDOQI) suggests an arteriovenous access, in the form of a fistula or graft due to the lower infection risk associated with AV-access use.

The creation of a fistula or shunt from the arterial system towards the venous system can produce various hemodynamic consequences among which is the increase in venous pressure leading to venous hypertension. This can manifest as edema of the affected extremity which can be distressing and debilitating to our chronically ill patients. Venotonic drugs act by enhancing sympathetic-mediated venous contractility and calcium sensitivity. It reduces leukocyte adhesion and inhibits production of leukocyte adhesion molecules thereby improving venous tone and decreasing edema.