van Damme H, Rorive G, Limet R
Department of Cardiovascular Surgery, University Hospital of Liége, Belgium.
Eur J Vasc Endovasc Surg. 1996 Feb;11(2):134-9. doi: 10.1016/s1078-5884(96)80041-4.
To assess whether acute renal failure, due to total or subtotal renal artery occlusion, can be reversed by kidney revascularisation.
A retrospective review of surgery for kidney salvage in anuric patients at a University Hospital.
From 1983 to 1993, eight patients were operated on for occlusive renal artery disease as a cause of acute renal failure, requiring preoperative haemodialysis. On admission the mean serum creatinine was 40 mg/l (354 mumol/dl). The oligoanuria lasted from 12 h to 3 weeks. Renal length of 8 cm or more and visualisation of a patent distal renal artery branches on aortography were arguments that return of renal function could be expected after revascularisation of these non-functioning kidneys.
Revascularisation restored immediate urine flow in six cases, with no further need for dialysis in four. Two patients remained oliguric despite successful reperfusion. One of them could be weaned from dialysis after 1 month. Two patients died postoperatively. Five of the eight patients left the hospital with restored renal function.
Patients with acute renal function deterioration due to ischemia of a single or both kidneys can benefit from prompt revascularisation, with significant recovery of renal function in most of them.
评估因肾动脉完全或部分闭塞所致的急性肾衰竭能否通过肾脏血管重建术得以逆转。
对某大学医院无尿患者挽救肾脏手术进行回顾性研究。
1983年至1993年期间，8例因闭塞性肾动脉疾病导致急性肾衰竭且术前需要血液透析的患者接受了手术。入院时平均血清肌酐为40mg/l（354μmol/dl）。少尿或无尿持续12小时至3周。肾长度达8cm或更长且主动脉造影显示肾动脉远端分支通畅是这些无功能肾脏血管重建后有望恢复肾功能的依据。
6例患者血管重建后立即恢复了尿流，其中4例不再需要透析。2例患者尽管再灌注成功仍持续少尿。其中1例在1个月后可停止透析。2例患者术后死亡。8例患者中有5例出院时肾功能恢复。
因一侧或双侧肾脏缺血导致急性肾功能恶化的患者可从及时的血管重建术中获益，大多数患者肾功能可显著恢复。
