Haemodialysis in haemophilia B: a case report. Challenges and strategies from a nephrology perspective.
Chiara Terzo, Rosario Maccarrone, Sandra La Rosa et al.
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Case in brief
A 68-year-old man with severe haemophilia B and kidney failure required kidney replacement therapy. He received prophylactic Idelvion® (albutrepenonacog alfa), then underwent arteriovenous fistula creation and started haemodialysis. No bleeding complications were reported. The report also reviews dialysis considerations in haemophilia B, including modality selection, vascular access, factor IX replacement and anticoagulation, and describes multidisciplinary planning to reduce bleeding risk.
What made this case unusual
The case demonstrates haemodialysis initiation, including arteriovenous fistula creation, in a patient with severe haemophilia B without reported bleeding complications under prophylactic factor IX replacement.
Diagnostic / clinical pearl
Severe haemophilia B does not necessarily preclude chronic haemodialysis; this case highlights the role of multidisciplinary planning, factor IX replacement and tailored anticoagulation to address bleeding risk.