Okamoto Yasuhisa, Nohmi Tosihiro, Seki Koichiro, Higa Yuki
Department of Anesthesiology, IMS Katushika Heart Center, Tokyo 124-0006.
Masui. 2013 Nov;62(11):1320-5.
Chronic renal failure (CRF) is related to cardiac diseases. Cardiac surgery is also related to postoperative acute kidney injury (AKI). It means heart and kidney have close relationship. We analyzed recent published data to understand how to manage CRF patients undergoing cardiovascular surgeries. We compared endovascular surgery and open procedure for aortic aneurysm, especially about contrast media-related renal damage, On or Off CABG or PCI for ischemic heart disease. We also discussed the relation between cardiopulmonary bypass and AKI and the risk factors causing AKI after CPB. Finally, we discussed prevention and treatment options of CPB related AKI, including furosemide, hANP mannitol, and statin. Published evidence in this area is still insufficient, but many studies are still carried out focusing on postoperative AKI. In the future we may be able to find the best answer for managing CRF patients undergoing cardiovascular surgeries.
慢性肾衰竭（CRF）与心脏疾病相关。心脏手术也与术后急性肾损伤（AKI）有关。这意味着心脏和肾脏关系密切。我们分析了近期发表的数据，以了解如何管理接受心血管手术的CRF患者。我们比较了主动脉瘤的血管内手术和开放手术，特别是关于造影剂相关的肾损伤、缺血性心脏病的冠状动脉旁路移植术（CABG）或经皮冠状动脉介入治疗（PCI）的开胸或非开胸情况。我们还讨论了体外循环与AKI的关系以及体外循环后导致AKI的危险因素。最后，我们讨论了体外循环相关AKI的预防和治疗选择，包括呋塞米、心房利钠肽、甘露醇和他汀类药物。该领域已发表的证据仍然不足，但仍有许多研究聚焦于术后AKI。未来我们或许能够找到管理接受心血管手术的CRF患者的最佳答案。
