Does Division of the Left Renal Vein During Aortic Surgery Adversely Affect Renal Function?

Ligation of the left renal vein is an accepted manoeuvre where it is difficult to access the pararenal abdominal aorta for the open treatment of aortic occlusive or aneurysmal disease. There is some controversy regarding the long-term effect of this on renal function. We describe the case of a 37-year-old gentleman who underwent an elective aorto-bifemoral bypass for aorto-iliac occlusive disease with symptoms of short distance claudication, with intra-operative ligation of the left renal vein. This was complicated by post-operative acute renal failure and haematuria, with CT findings of left renal venous dilatation and peri-renal stranding. The patient underwent successful left renocaval bypass with reversed great saphenous vein, with subsequent resolution of haematuria and improvement in renal function. The syndrome of acute renal failure and haematuria is a rare but possible complication of left renal vein ligation during aortic surgery, and restoration of renal venous outflow via renocaval bypass in this instance was an effective method of treating this complication.

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The Effect of Left Renal Vein Division on Renal Function Following Open Abdominal Aortic Surgery Using Propensity Score Matching Analysis

Annals of Vascular Surgery ◽

10.1016/j.avsg.2019.02.035 ◽

2020 ◽

Vol 62 ◽

pp. 232-237 ◽

Cited By ~ 1

Author(s):

Byeoung-Hoon Chung ◽

Ji-Hee Kang ◽

Seon-Hee Heo ◽

Yang-Jin Park ◽

Young-Wook Kim ◽

...

Keyword(s):

Renal Function ◽

Propensity Score ◽

Propensity Score Matching ◽

Renal Vein ◽

Left Renal Vein ◽

Aortic Surgery ◽

Abdominal Aortic Surgery ◽

Propensity Score Matching Analysis ◽

Abdominal Aortic ◽

Renal Vein Division

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Contralateral renal function after unilateral renal vein ligation

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1959.197.5.1093 ◽

1959 ◽

Vol 197 (5) ◽

pp. 1093-1096

Author(s):

Joseph H. Perlmutt

Keyword(s):

Renal Function ◽

Renal Vein ◽

Left Renal Vein ◽

Free Water ◽

Urine Osmolality ◽

Tubular Reabsorption ◽

Experimental Conditions ◽

Free Water Clearance ◽

Excretion Rates ◽

The Right

The effect of increased pressure in one kidney, produced by ligation of its vein, on contralateral renal function was investigated in eight anesthetized dogs. Kidney function was determined under the same experimental conditions in five dogs, but without renal vein ligation. For the latter group, renal function, on the average, remained reasonably stable. After left renal vein ligation, findings for the right kidney were as follows: a) decreased urine flow, amounting maximally to 9.5–41.4% of control flows; b) slight increase of questionable significance in creatinine clearance; c) inconstant changes in PAH clearance; d) increase in urine osmolality to hypertonic values; e) decrease in solute-free water clearance; f) slight rise of questionable significance in total solute clearance; and g) either no change or inconstant changes in excretion rates Na+ and K+. The data indicate that the oliguria resulted solely from increased renal tubular reabsorption of water, suggesting liberation of antidiuretic hormone as the possible mechanism. Direct nervous influences on tubular reabsorption of water cannot, however, be presently ruled out.

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Effect of Intraoperative Division of the Left Renal Vein on the Fate of Renal Function and Left Renal Volume After Open Repair of Para- and Juxtarenal Aortic Aneurysm

Circulation Journal ◽

10.1253/circj.cj-19-0383 ◽

2019 ◽

Vol 83 (9) ◽

pp. 1844-1850

Author(s):

Masayuki Sugimoto ◽

Noriko Takahashi ◽

Kiyoaki Niimi ◽

Akio Kodama ◽

Hiroshi Banno ◽

...

Keyword(s):

Renal Function ◽

Aortic Aneurysm ◽

Renal Vein ◽

Open Repair ◽

Left Renal Vein ◽

Renal Volume

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Surgical Approach to a Large Left Adrenocortical Mass with Associated Tumour Thrombosis of the Left Renal Vein: Preservation of the Ipsilateral Kidney

Advances in Urology ◽

10.1155/2009/365805 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Manuel Pérez Utrilla ◽

Carlos Nuñez Mora ◽

Alejandro Rojo Sebastián ◽

Pedro M. Cabrera Castillo ◽

José M. García Mediero

Keyword(s):

Renal Function ◽

Inferior Vena Cava ◽

Surgical Approach ◽

Renal Vein ◽

Adrenal Mass ◽

Inferior Vena ◽

Elective Surgery ◽

Left Renal Vein ◽

Vena Cava ◽

Tumour Thrombus

A sixty-years-old male with diagnosis of a left adrenal mass ( mm) with associated tumour thrombosis of the left renal vein with no clear signs of thrombosis of the inferior vena cava was admitted for elective surgery Finally an adrenalectomy and excision of tumour thrombus preserving the ipsilateral kidney was made. Despite of the complex vascular management, this kind of approaches allow to preserve normal renal function in patients with future nephrotoxic treatment like cisplatin.

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