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单功能肾肾动脉狭窄患者的严重急性肾损伤:经皮腔内血管成形术加支架置入术后肾功能迅速恢复正常的病例报告

Severe acute kidney injury in a patient with renal artery stenosis of a single-functioning kidney: A case report of rapid normalisation of the renal function after percutaneous transluminal angioplasty with stent placement.

作者信息

Seydoux Claire, Hemett Ould Maouloud, Périard Daniel, Descombes Eric

机构信息

Department of Internal Medicine, University and Hospital of Fribourg, Fribourg, Switzerland.

Service of Nephrology, University and Hospital of Fribourg, Fribourg, Switzerland.

出版信息

SAGE Open Med Case Rep. 2023 Nov 5;11:2050313X231209639. doi: 10.1177/2050313X231209639. eCollection 2023.

Abstract

Revascularisation of renal arterial stenosis in acute settings, such as uncontrolled arterial hypertension, flash pulmonary oedema and/or acute renal failure, has shown controversial results in observational and prospective studies. Current guidelines do not recommend revascularisation in the occurrence of renal failure as revascularisation and best medical treatment have shown similar long-term outcomes on renal function. We describe a case of acute degradation of the renal function (with oligo-anuria and a peak creatinine of 462 µmol/L) after the re-introduction of an angiotensin-II receptor blocker (irbesartan) in a 66-year-old Caucasian diabetic male patient with bilateral renal stenosis and a right-sided single-functioning kidney, with a rapid improvement of the renal function which normalized 5 days after percutaneous angioplasty and stenting of the right renal artery.

摘要

在急性情况下,如未控制的动脉高血压、急性肺水肿和/或急性肾衰竭时,对肾动脉狭窄进行血管重建术,在观察性研究和前瞻性研究中结果存在争议。目前的指南不建议在肾衰竭时进行血管重建术,因为血管重建术和最佳药物治疗在肾功能方面显示出相似的长期结果。我们描述了一名66岁患有双侧肾狭窄和右侧单功能肾的白种人糖尿病男性患者,在重新使用血管紧张素II受体阻滞剂(厄贝沙坦)后出现肾功能急性恶化(少尿-无尿,肌酐峰值为462µmol/L),在经皮血管成形术和右侧肾动脉支架置入术后5天肾功能迅速改善并恢复正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af37/10629318/2417aa4265d7/10.1177_2050313X231209639-fig1.jpg

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