scholarly journals Renal Function Salvage After Delayed Endovascular Revascularisation After Acute Renal Artery Occlusion in Patients with Fenestrated/Branched EVAR or Renal Artery Bypass

2019 ◽  
Vol 58 (6) ◽  
pp. e699
Author(s):  
Franziska Heidemann ◽  
Tilo Kölbel ◽  
E. Sebastian Debus ◽  
Holger Diener ◽  
Sebastian Carpenter ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Artery Bypass ◽  
Artery Occlusion ◽  
Renal Artery Occlusion

Renal Function Salvage After Delayed Endovascular Revascularization of Acute Renal Artery Occlusion in Patients With Fenestrated-Branched Endovascular Aneurysm Repair or Visceral Debranching

2018 ◽  
Vol 25 (4) ◽  
pp. 466-473 ◽  
Author(s):  
Franziska Heidemann ◽  
Tilo Kölbel ◽  
E. Sebastian Debus ◽  
Holger Diener ◽  
Sebastian W. Carpenter ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Stent Graft ◽  
Aortic Surgery ◽  
Artery Occlusion ◽  
Aspiration Thrombectomy ◽  
Endovascular Revascularization ◽  
Renal Artery Occlusion ◽  
Local Lysis

Purpose: To analyze the renal function and outcome after delayed (>6 hours) endovascular revascularization of acute renal artery occlusion (RAO) in patients with fenestrated-branched endovascular aneurysm repairs (EVARs) or open visceral debranching. Methods: A single-center retrospective analysis was conducted involving 7 patients (mean age 61 years, range 49–72; 5 women) with 9 RAOs treated with endovascular revascularization between December 2014 and March 2017. Three patients had a solitary kidney with chronic renal insufficiency; 1 patient had bilateral occlusions as the acute event. Initial aortic surgery included 5 branched and 1 fenestrated EVAR as well as 1 open visceral debranching operation. Revascularization of the RAO was performed using aspiration thrombectomy, local lysis therapy, and stent-graft relining. The median time between initial aortic surgery and RAO was 10 months (range 0.5–17). Results: Median renal ischemic time to revascularization was 24 hours (range 7–168). Technical success was 100%, with 1 procedure-related access complication. Temporary dialysis dependency occurred in 4 patients. Mean in-hospital stay was 17 days (range 7–32) with 1 postoperative death at day 10 due to cardiac arrest of unknown cause. Mean follow-up was 10.3 months (range 1.5–27) in 5 of 6 discharged patients. During follow-up, 1 reintervention for recurrent occlusion was performed. At follow-up imaging, all renal arteries were patent. No permanent dialysis dependency occurred. Conclusion: Renal function can be salvaged by delayed revascularization for RAO with prolonged renal ischemia. The endovascular approach with aspiration thrombectomy, local lysis, and stent-graft relining is a feasible technique for revascularization after RAO in patients with fenestrated-branched EVAR or open visceral debranching.

scholarly journals Restoration of renal function by a novel prostaglandin EP4 receptor-derived peptide in models of acute renal failure

2013 ◽  
Vol 304 (1) ◽  
pp. R10-R22 ◽  
Author(s):  
Martin Leduc ◽  
Xin Hou ◽  
David Hamel ◽  
Melanie Sanchez ◽  
Christiane Quiniou ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Artery ◽  
Artery Occlusion ◽  
Hek293 Cells ◽  
Heme Oxygenase 1 ◽  
Histological Changes ◽  
Ep4 Receptor ◽  
Renal Artery Occlusion

Acute renal failure (ARF) is a serious medical complication characterized by an abrupt and sustained decline in renal function. Despite significant advances in supportive care, there is currently no effective treatment to restore renal function. PGE2 is a lipid hormone mediator abundantly produced in the kidney, where it acts locally to regulate renal function; several studies suggest that modulating EP4 receptor activity could improve renal function following kidney injury. An optimized peptidomimetic ligand of EP4 receptor, THG213.29, was tested for its efficacy to improve renal function (glomerular filtration rate, renal plasma flow, and urine output) and histological changes in a model of ARF induced by either cisplatin or renal artery occlusion in Sprague-Dawley rats. THG213.29 modulated PGE2-binding dissociation kinetics, indicative of an allosteric binding mode. Consistently, THG213.29 antagonized EP4-mediated relaxation of piglet saphenous vein rings, partially inhibited EP4-mediated cAMP production, but did not affect Gαi activation or β-arrestin recruitment. In vivo, THG213.29 significantly improved renal function and histological changes in cisplatin- and renal artery occlusion-induced ARF models. THG213.29 increased mRNA expression of heme-oxygenase 1, Bcl2, and FGF-2 in renal cortex; correspondingly, in EP4-transfected HEK293 cells, THG213.29 augmented FGF-2 and abrogated EP4-dependent overexpression of inflammatory IL-6 and of apoptotic death domain-associated protein and BCL2-associated agonist of cell death. Our results demonstrate that THG213.29 represents a novel class of diuretic agent with noncompetitive allosteric modulator effects on EP4 receptor, resulting in improved renal function and integrity following acute renal failure.

The Application of R.E.N.A.L. Nephrometry Score In Laparoscopic Partial Nephrectomy With Zero Ischemia And Sutureless

2021 ◽  
Author(s):  
Yi Mu ◽  
Kehang Chen ◽  
Jun He ◽  
Peng Chen ◽  
Miao Liu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Renal Artery ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Artery Occlusion ◽  
Nephrometry Score ◽  
Renal Artery Occlusion ◽  
Zero Ischemia

Abstract Background: To evaluate the application of R.E.N.A.L. nephrometry score (RNS) in laparoscopic partial nephrectomy (LPN) with zero ischemia and sutureless surgery, and to explore the efficacy and safety of zero ischemia and seamless LPN in the treatment of renal cell carcinoma.Methods: The clinical data of 67 patients with renal cell carcinoma treated by LPN in the affiliated Hospital of Guizhou Medical University from January 2016 to July 2020 were analyzed retrospectively. The patients were divided into renal artery occlusion group (n=31) and non-occlusion group (n=36). All cases were divided according to their RNS (low, moderate, and high), and the perioperative condition, postoperative complications, postoperative recovery and changes of renal function in the two groups were analyzed.Results: According to the RNS, all cases were classified in low-complex. Both groups successfully completed the operation without operative complications. Compared with the renal artery occlusion group, the non-occlusion group had a shorter operation time (35.51±20.48 min), shorter hospital stay (6.72±4.39 d), and no significant difference in intraoperative blood loss(50.39±30.19 ml). During the 6-month follow-up, the creatinine value of the renal function in the non-occlusion group (78.47±10.98μmol/L) was lower than that in the occlusion group(98.21±8.06μmol/L).Conclusion: Zero-ischemia sutureless LPN technique can effectively reduce the time of ischemia and avoid renal ischemia-reperfusion injury. This surgical technique may be a feasible surgical method for the treatment of low RNS renal cell carcinoma.

Patterns of Renal Function in Hypertension Due to Unilateral Renal Artery Occlusion

1992 ◽  
Vol 14 (6) ◽  
pp. 1067-1081 ◽  
Author(s):  
Yuji Tsuji ◽  
David A. Goldfarb ◽  
Zenjiro Masaki ◽  
Carlos M. Ferrario
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Artery Occlusion ◽  
Renal Artery Occlusion

Nephron-Sparing Surgery: The Effect of Surface Cooling and Temporary Renal Artery Occlusion on Renal Function

2009 ◽  
Vol 82 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Hasan Bakirtas ◽  
Muzaffer Eroglu ◽  
Seniha Naldoken ◽  
Ziya Akbulut ◽  
U. Yener Tekdogan
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Artery Occlusion ◽  
Nephron Sparing Surgery ◽  
Surface Cooling ◽  
Nephron Sparing ◽  
Renal Artery Occlusion ◽  
Effect Of Surface

scholarly journals Successful revascularization of the kidney: Case reports

2004 ◽  
Vol 132 (9-10) ◽  
pp. 323-326
Author(s):  
Lazar Davidovic ◽  
Radomir Sindjelic ◽  
Mirjana Stanojevic ◽  
Ilija Kuzmanovic ◽  
Momcilo Colic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Renal Function ◽  
Renal Artery ◽  
Renovascular Hypertension ◽  
Medical Therapy ◽  
Case Reports ◽  
Artery Occlusion ◽  
First Case ◽  
Renal Artery Occlusion

Three cases of successful kidney revascularization and recovery of renal function are presented in this study. In all three cases, renal failure and renovascular hypertension were caused by renal artery occlusion associated with aortic aneurysm (two abdominal and one thoracoabdominal). Prior to operation, one patient required dialysis 4 months, one 25 days and one 2 days. After kidney revascularization, renal function recovered immediately in the first case, in the second case after three months, and in the third case after 10 days. In one case, blood pressure restored to normal without medical therapy, while in two other cases blood pressure decreased nearly to normal with minimal medical therapy. In appropriately selected cases, revascularization of the occluded renal artery is recommended for treatment of both renal failure and renovascular hypertension. In such cases, collateral circulation is crucial to enable the preservation of dysfunctional kidney.

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