High Output Cardiac Failure on Maintenance Hemodialysis Secondary to a Post-Biopsy Renal Arteriovenous Fistula

A case of post-biopsy renal arteriovenous fistula causing high output cardiac failure was diagnosed one year after the start of maintenance hemodialysis, confirmed by radionuclide studies, and successfully treated with nephrectomy. Management was complicated by superimposed digitalis intoxication. It is suggested that the presence of the renal arteriovenous fistula might account for the accelerated deterioration in renal function observed in this patient.