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整个主动脉树严重钙化伴肾动脉次全闭塞:急性肾损伤、缺血性肾病及组织存活问题——病例报告

Significant Calcification of an Entire Aortic Tree with Renal Artery Subocclusion: Acute Kidney Injury, Ischemic Kidney Disease, and the Tissue Viability Question-A Case Report.

作者信息

Baralić Marko, Gajić Selena, Kezić Aleksandra, Bontić Ana, Pavlović Jelena, Brković Voin, Karadžić Ristanović Vidna, Bjelić Danka, Životić Maja, Radojević-Škodrić Sanja, Antonić Želimir, Ilijevski Nenad, Radović Milan

机构信息

Clinic of Nephrology, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, Dr Subotića Starijeg 8, 11000 Belgrade, Serbia.

出版信息

Life (Basel). 2025 Jan 11;15(1):82. doi: 10.3390/life15010082.

Abstract

BACKGROUND

Undiagnosed and untreated atherosclerotic renal artery stenosis (ARAS) can result in end-stage kidney disease (ESKD). To obtain an accurate diagnosis, it is crucial to recognize the symptoms and signs suggesting renal artery stenosis (RAS) and perform appropriate diagnostic and treatment procedures afterward.

CASE PRESENTATION

We present a case of a 60-year-old female patient with hypertensive crisis, acute heart failure (HF), and pulmonary edema as the initial signs of acute kidney injury (AKI) caused by right RAS and left renal artery occlusion in the presence of severe aortic atherosclerosis revealed on computed tomography angiography (CTA) of the abdomen. The patient's renal function recovered completely following percutaneous transluminal angioplasty (PTA) with stent implantation in the right renal artery at the site of subocclusion.

CONCLUSIONS

Even in patients with concomitant disorders like type-2 diabetes mellitus (T2DM), hypertension (HTN), or HF, the dilatation of significantly narrowed renal arteries due to severe calcifications can result in complete renal function recovery.

摘要

背景

未诊断和未治疗的动脉粥样硬化性肾动脉狭窄(ARAS)可导致终末期肾病(ESKD)。为获得准确诊断,识别提示肾动脉狭窄(RAS)的症状和体征并随后进行适当的诊断和治疗程序至关重要。

病例报告

我们报告一例60岁女性患者,其以高血压危象、急性心力衰竭(HF)和肺水肿为急性肾损伤(AKI)的初始体征,该急性肾损伤由右肾动脉狭窄和左肾动脉闭塞引起,腹部计算机断层血管造影(CTA)显示存在严重的主动脉粥样硬化。在右肾动脉亚闭塞部位进行经皮腔内血管成形术(PTA)并植入支架后,患者的肾功能完全恢复。

结论

即使在患有2型糖尿病(T2DM)、高血压(HTN)或HF等合并症的患者中,因严重钙化导致的显著狭窄肾动脉的扩张也可使肾功能完全恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b4a/11766728/c7f21ce118cb/life-15-00082-g001.jpg

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