The Effects of Acute Renal Failure on Long-Term 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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Plasma D Dimer: A Useful Marker of Fibrin Breakdown in Renal Failure

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646627 ◽

1989 ◽

Vol 61 (03) ◽

pp. 522-525 ◽

Cited By ~ 32

Author(s):

M P Gordge ◽

R W Faint ◽

P B Rylance ◽

H Ireland ◽

D A Lane ◽

...

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Monoclonal Antibodies ◽

Diabetic Nephropathy ◽

Renal Disease ◽

Plasma Concentrations ◽

Significant Negative Correlation ◽

Healthy Controls ◽

D Dimer

SummaryD dimer and other large fragments produced during the breakdown of crosslinked fibrin may be measured by enzyme immunoassay using monoclonal antibodies. In 91 patients with renal disease and varying degrees of renal dysfunction, plasma D dimer showed no correlation with renal function, whereas FgE antigen, a fibrinogen derivative which is known to be cleared in part by the kidney, showed a significant negative correlation with creatinine clearance. Plasma concentrations of D dimer were, however, increased in patients with chronic renal failure (244 ± 3l ng/ml) (mean ± SEM) and diabetic nephropathy (308 ± 74 ng/ml), when compared with healthy controls (96 ± 13 ng/ml), and grossly elevated in patients with acute renal failure (2,451 ± 1,007 ng/ml). The results indicate an increase in fibrin formation and lysis, and not simply reduced elimination of D dimer by the kidneys, and are further evidence of activated coagulation in renal disease. D dimer appears to be a useful marker of fibrin breakdown in renal failure.

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Effect of Curcuma longa and Galega orientalis on renal function in rats with experimental diabetes mellitus and acute renal failure

ZHurnal «Patologicheskaia fiziologiia i eksperimental`naia terapiia» ◽

10.25557/0031-2991.2019.04.88-95 ◽

2019 ◽

pp. 88-95

Author(s):

Р.И. Айзман ◽

А.П. Козлова ◽

Е.И. Гордеева ◽

М.С. Головин ◽

Г.А. Корощенко ◽

...

Keyword(s):

Diabetes Mellitus ◽

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Experimental Diabetes ◽

Curcuma Longa ◽

Diabetic Rats ◽

Standard Diet ◽

Experimental Diabetes Mellitus ◽

Galega Orientalis

Цель - исследование влияния куркумы длинной и галеги восточной на осмо- и ионорегулирующую функции почек крыс при аллоксан-индуцированном сахарном диабете и острой почечной недостаточности в эксперименте. Методика. Эксперименты выполнены на самцах крыс Wistar (n=70) с моделью сахарного диабета (1-я серия) и острой почечной недостаточности (2-я серия). В обеих сериях животные были поделены на 3 группы: крыс 1-й группы содержали на стандартном корме, крысам остальных групп в корм добавляли куркуму (2-я группа) или галегу (3-я группа) (2% от массы корма). На 7-е сут эксперимента проводили исследование диуретической и ионоуретической функций почек натощак и после 5% водной нагрузки. Концентрацию ионов в моче и плазме определяли методом пламенной фотометрии; осмотическую концентрацию биологических жидкостей - методом криоскопии; биохимические показатели крови - колориметрическим методом. Результаты. У животных с сахарным диабетом фоновый диурез, а также экскреция натрия и калия были статистически значимо выше, чем у контрольных животных. При острой почечной недостаточности наблюдался более низкий уровень диуреза и ионоуреза, особенно после водной нагрузки. Прием куркумы и галеги вызывал улучшение осмо- и ионорегулирующей функции почек у крыс с сахарным диабетом, и практически не влиял на эти функции почек при острой почечной недостаточности. Заключение. При сахарном диабете оба фитопрепарата вызывали понижение концентрации глюкозы, креатинина, мочевины и улучшение ионно-осмотических показателей плазмы крови, при этом эффект куркумы был выражен отчетливее. При острой почечной недостаточности эти фитопрепараты не давали описанного эффекта. Aim. To study effects of the phytomedicines, Curcuma longa and Galega orientalis, on osmosis- and ion-regulating renal functions in rats with experimental diabetes mellitus (DM) and acute renal failure (ARF). Methods. Experiments were performed in two series on Wistar male rats (n=70) with modeled diabetes mellitus (series 1) and acute renal failure (series 2). In each series, the animals were divided into 3 groups, 1) rats of group 1 receiving a standard diet; 2) rats of groups 2 and 3 receiving a standard diet supplemented with turmeric or galega (2% of food weight), respectively. On the 7th day of the experiment, the diuretic and ionuretic renal function was studied in fasting state and after 5% water loading. Concentrations of ions in urine and plasma were determined by flame photometry; osmotic concentrations of biological fluids were measured by cryoscopy; blood biochemical parameters were measured by colorimetry. Results. In diabetic rats, background diuresis and sodium and potassium excretion were significantly higher than in the control animals. In rats with acute renal failure, diuresis and ionuresis were significantly lower, particularly after the water loading. Turmeric and galega supplementation improved the osmotic and ion-regulating renal function in diabetic rats and left practically unchanged these functions in rats with acute renal failure. Conclusion. In rats with diabetes mellitus, both herbal remedies reduced concentrations of glucose, creatinine, and urea and improved ion-osmotic parameters of blood plasma with a more pronounced effect of turmeric. In acute renal failure, these phytomedicines did not produce the described effects.

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Faculty Opinions recommendation of Predictors of postoperative acute renal failure after noncardiac surgery in patients with previously normal renal function.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1099139.555351 ◽

2008 ◽

Author(s):

Lee Fleisher ◽

Michael Banks

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Normal Renal Function ◽

Noncardiac Surgery

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Acute renal failure in a neonate due to pelviureteric candidal bezoars successfully treated with long-term systemic fluconazole

Acta Paediatrica ◽

10.1111/j.1651-2227.1992.tb12342.x ◽

1992 ◽

Vol 81 (9) ◽

pp. 709-711 ◽

Cited By ~ 11

Author(s):

KA Bergman ◽

JF Meis ◽

AM Horrevorts ◽

L Monnens

Keyword(s):

Renal Failure ◽

Acute Renal Failure

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Simultaneous blockade of endothelin A and B receptors in ischemic acute renal failure is detrimental to long-term kidney function

Kidney International ◽

10.1046/j.1523-1755.2001.0590041333.x ◽

2001 ◽

Vol 59 (4) ◽

pp. 1333-1341 ◽

Cited By ~ 55

Author(s):

Josephine Maree Forbes ◽

Timothy David Hewitson ◽

Gavin James Becker ◽

Colin Lindsay Jones

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Kidney Function ◽

Endothelin A ◽

Ischemic Acute Renal Failure

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Predictors of Postoperative Acute Renal Failure after Noncardiac Surgery in Patients with Previously Normal Renal Function

Anesthesiology ◽

10.1097/01.anes.0000290588.29668.38 ◽

2007 ◽

Vol 107 (6) ◽

pp. 892-902 ◽

Cited By ~ 323

Author(s):

Sachin Kheterpal ◽

Kevin K. Tremper ◽

Michael J. Englesbe ◽

Michael O’Reilly ◽

Amy M. Shanks ◽

...

Keyword(s):

Renal Failure ◽

Renal Function ◽

Acute Renal Failure ◽

Creatinine Clearance ◽

Normal Renal Function ◽

Noncardiac Surgery ◽

Intraoperative Management ◽

All Cause Mortality ◽

Calculated Creatinine Clearance ◽

Preoperative Predictors

Background The authors investigated the incidence and risk factors for postoperative acute renal failure after major noncardiac surgery among patients with previously normal renal function. Methods Adult patients undergoing major noncardiac surgery with a preoperative calculated creatinine clearance of 80 ml/min or greater were included in a prospective, observational study at a single tertiary care university hospital. Patients were followed for the development of acute renal failure (defined as a calculated creatinine clearance of 50 ml/min or less) within the first 7 postoperative days. Patient preoperative characteristics and intraoperative anesthetic management were evaluated for associations with acute renal failure. Thirty-day, 60-day, and 1-yr all-cause mortality was also evaluated. Results A total of 65,043 cases between 2003 and 2006 were reviewed. Of these, 15,102 patients met the inclusion criteria; 121 patients developed acute renal failure (0.8%), and 14 required renal replacement therapy (0.1%). Seven independent preoperative predictors were identified (P < 0.05): age, emergent surgery, liver disease, body mass index, high-risk surgery, peripheral vascular occlusive disease, and chronic obstructive pulmonary disease necessitating chronic bronchodilator therapy. Several intraoperative management variables were independent predictors of acute renal failure: total vasopressor dose administered, use of a vasopressor infusion, and diuretic administration. Acute renal failure was associated with increased 30-day, 60-day, and 1-yr all-cause mortality. Conclusions Several preoperative predictors previously reported to be associated with acute renal failure after cardiac surgery were also found to be associated with acute renal failure after noncardiac surgery. The use of vasopressor and diuretics is also associated with acute renal failure.

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