Gookin J L, Stone E A, Spaulding K A, Berry C R
Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA.
J Am Vet Med Assoc. 1996 Jun 15;208(12):2020-6.
To evaluate indications for and complications, efficacy, and effects on renal function of unilateral nephrectomy in dogs with renal disease, and to evaluate the role that scintigraphy had in the decision to excise a kidney.
Retrospective case series.
30 dogs with renal disease that underwent unilateral nephrectomy. A comparison group of 12 dogs with renal calculi that underwent renal scintigraphy but not nephrectomy was included.
Indications for nephrectomy included renal or ureteral calculi (n = 10), renal mass (8), chronic pyelonephritis (5), perirenal mass (3), severe hydronephrosis and hydroureter (3), and renal hypoplasia with ureteral ectopia (1). None of the dogs were azotemic before surgery. Renal scintigraphy apparently influenced the decision to perform nephrectomy, because in 14 of 16 dogs that underwent nephrectomy, the affected kidney contributed < or = 33% of the total glomerular filtration rate, but in 6 of 8 comparison dogs that underwent nephrotomy, the affected kidney contributed > 33% of total glomerular filtration rate. Complications of nephrectomy included oliguria (5) and organ laceration (2). Mean +/- SD final serum creatinine concentration for 16 dogs alive at least 6 months after nephrectomy was 2.2 +/- 1.8 mg/dl. Three dogs had chronic renal failure of undetermined cause at the time of death. Nephrectomy did not completely resolve the underlying disease in 13 dogs. Renal function was evaluated in 6 dogs 2 to 3.5 years after nephrectomy and was impaired in 4. None of the dogs were anemic, azotemic, proteinuric, or hypertensive. Survival time varied depending on the underlying disease.
Multiple factors contributed to the decision to perform nephrectomy. Unilateral nephrectomy resulted in few serious complications and was not detrimental to the remaining kidney, but did not always resolve the underlying disease.
评估肾病犬单侧肾切除术的适应证、并发症、疗效及对肾功能的影响，并评估肾闪烁显像在决定切除患肾时所起的作用。
回顾性病例系列研究。
30只接受单侧肾切除术的肾病犬。纳入12只患有肾结石且接受了肾闪烁显像但未行肾切除术的犬作为对照组。
肾切除术的适应证包括肾或输尿管结石（n = 10）、肾肿物（8例）、慢性肾盂肾炎（5例）、肾周肿物（3例）、严重肾积水和输尿管积水（3例）以及肾发育不全伴输尿管异位（1例）。术前无犬出现氮质血症。肾闪烁显像显然影响了肾切除术的决策，因为在接受肾切除术的16只犬中，有14只患肾对总肾小球滤过率的贡献≤33%，但在接受肾切开术的8只对照犬中，有6只患肾对总肾小球滤过率的贡献>33%。肾切除术的并发症包括少尿（5例）和器官撕裂伤（2例）。肾切除术后至少存活6个月的16只犬的平均±标准差最终血清肌酐浓度为2.2±1.8mg/dl。3只犬在死亡时患有病因不明的慢性肾衰竭。肾切除术未能完全解决13只犬的潜在疾病。在肾切除术后2至3.5年对6只犬的肾功能进行了评估，其中4只犬的肾功能受损。所有犬均无贫血、氮质血症、蛋白尿或高血压。生存时间因潜在疾病而异。
多种因素促成了肾切除术的决策。单侧肾切除术导致的严重并发症较少，对剩余肾脏无害，但并不总能解决潜在疾病。
