scholarly journals Severe Acute Kidney Injury With Significant Uremia in an Infant Found to Have Inferior Vena Cava, Bilateral Renal Vein, and Bilateral Renal Artery Thromboses

2018 ◽  
Vol 18 (4) ◽  
pp. 417-422
Author(s):  
Hannah Lively-Endicott ◽  
Angelina M. Dixon ◽  
Joyce Varghese
Keyword(s):  
Acute Kidney Injury ◽  
Inferior Vena Cava ◽  
Renal Artery ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury ◽  
Bilateral Renal Artery

scholarly journals Acute Kidney Injury Associated with Renal Cell Carcinoma Complicated by Renal Vein and Inferior Vena Cava Involvement

2016 ◽  
Vol 55 (17) ◽  
pp. 2447-2452 ◽  
Author(s):  
Taro Sugase ◽  
Tetsu Akimoto ◽  
Taro Kubo ◽  
Toshimi Imai ◽  
Naoko Otani-Takei ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Acute Kidney Injury ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury

scholarly journals Inferior vena cava compression and acute kidney injury

2019 ◽  
Vol 30 (3) ◽  
pp. 747
Author(s):  
Naohiko Imai ◽  
Hiroyasu Nakano ◽  
Yugo Shibagaki
Keyword(s):  
Acute Kidney Injury ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury

scholarly journals Risk factors for acute kidney injury after unilateral radical nephrectomy and inferior vena cava thrombectomy under cardiopulmonary bypass: a retrospective study

2021 ◽  
Author(s):  
Qi Zhang ◽  
Ming Li ◽  
Dongmei Fu ◽  
Dongxin Wang ◽  
Shiqi Diao
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Retrospective Study ◽  
Cardiopulmonary Bypass ◽  
Inferior Vena Cava ◽  
Radical Nephrectomy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury ◽  
Postoperative Aki

Abstract In patients with renal cell carcinoma (RCC) and cancer-related thrombosis in the inferior vena cava (IVC) or right atrium (AT), it is still unknown whether nephrectomy, anesthesia, and surgical trauma can cause postoperative acute kidney injury (AKI) and what are the risk factors for AKI. To examine the incidence and risk factors of postoperative AKI in patients who underwent unilateral radical nephrectomy and cardiopulmonary bypass (CPB)-assisted thrombectomy in the IVC and/or atrial AT due to RCC complicated with cancer-associated thrombosis. This retrospective study included patients who underwent unilateral radical nephrectomy and CPB-assisted thrombectomy in the inferior vena cava and/or atrial pulmonary artery due to RCC, under general anesthesia, from December 2011 to June 2015, at Peking University First Hospital. Among 31 patients, 15 (48.4%) had postoperative AKI. Compared with the non-AKI group (n = 16), patients in the AKI group (n = 15) were older (59.0 ± 8.7 vs. 48.5 ± 12.9 years, P = 0.012) had smaller intraoperative urine volume (1225 ± 639 vs. 1685 ± 597 mL, P = 0.048). There were no differences in preoperative creatinine clearance. Age (OR = 1.10, 95%CI: 1.02–1.20, P = 0.020) was independently associated with AKI occurrence. The patients undergoing unilateral radical nephrectomy and CPB-assisted IVC thrombectomy have a high rate of AKI. Older ones are at a higher risk of postoperative AKI.

scholarly journals Prevalence and risk factors of myocardial and acute kidney injury following radical nephrectomy with vena cava thrombectomy: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Bin Hua ◽  
Xue Li ◽  
Dong-Xin Wang
Keyword(s):  
Acute Kidney Injury ◽  
Inferior Vena Cava ◽  
Radical Nephrectomy ◽  
Lower Risk ◽  
Myocardial Injury ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury ◽  
Long Duration ◽  
Duration Of Surgery

Abstract Background Radical nephrectomy with thrombectomy is the mainstay treatment for patients with renal cell carcinoma with vena cava thrombus. But the procedure is full of challenge, with high incidence of major complications and mortality. Herein, we investigated the incidence and predictors of myocardial injury and acute kidney injury (AKI) in patients following radical nephrectomy with inferior vena cava thrombectomy. Methods Patients who underwent nephrectomy with thrombectomy between January 2012 and June 2020 were retrospectively reviewed. Myocardial injury was diagnosed when peak cardiac troponin I was higher than 0.03 ng/ml. AKI was diagnosed according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression models were used to identify predictors of myocardial injury or AKI after surgery. Results A total of 143 patients were included in the final analysis. Myocardial injury and AKI occurred in 37.8 and 42.7% of patients after this surgery, respectively. Male sex (odds ratio [OR] 0.27, 95% confidence interval [CI] 0.10–0.71; P = 0.008) was associated with a lower risk, whereas high level Mayo classification (compared with Mayo level I + II, Mayo level III + IV: OR 4.21, 95% CI 1.42–12.4; P = 0.009), acute normovolemic hemodilution before surgery (OR 2.66, 95% CI 1.10–6.41; P = 0.029), long duration of intraoperative tachycardia (per 20 min: OR 1.49, 95% CI 1.10–2.16; P = 0.036), and long duration of surgery (per 1 h, OR 1.48, 95% CI 1.03–2.16, P = 0.009) were associated with a higher risk of myocardial injury. High body mass index (OR 1.18, 95% CI 1.06–1.33; P = 0.004) and long duration of intraoperative hypotension (per 20 min: OR 1.30, 95% CI 1.04–1.64; P = 0.024) were associated with a higher risk, whereas selective renal artery embolism before surgery (OR 0.20, 95% CI 0.07–0.59, P = 0.004) was associated with a lower risk of AKI. Conclusion Myocardial injury and AKI were common in patients recovering from radical nephrectomy with inferior vena cava thrombectomy. Whether interventions targeting the above modifiable factors can improve outcomes require further studies.

scholarly journals Inferior vena cava dimensions in patients with acute kidney injury

2016 ◽  
Vol 4 (15) ◽  
pp. 9
Author(s):  
Andres Yepes-Hurtado ◽  
Sabry Omar ◽  
Khalid Monzer ◽  
Raed Alalawi ◽  
Kenneth Nugent
Keyword(s):  
Acute Kidney Injury ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Injury ◽  
Fluid Administration ◽  
Maximum Diameter ◽  
Fractional Excretion Of Sodium ◽  
The Mean ◽  
Change In Mean

Background: Volume contraction frequently contributes to the development of acute kidney injury.  The rapid assessment of volume status in patients with acute kidney injury could improve decision making and outcomes. Methods: The maximum and minimum diameters and percent collapsibility of the inferior vena cava (IVC) were measured in 30 patients admitted to the medical intensive care unit with laboratory evidence of acute kidney injury.  These measurements were made on the day of admission and 24 hours following admission.  Information about age, gender, body mass index, serum creatinine levels, and fluid balances was recorded. Results: This study included 30 patients with a mean age is 62.4 ±16.0 years.  The mean initial creatinine was 4.3 ± 4.2 mg/dL (range: 1.7 mg/dL to 22.1 mg/dL).  The mean fractional excretion of sodium was 2.06 ± 2.65%.  The mean maximum diameter of inferior vena cava was 1.8 ± 0.5 cm with the range is 0.4-2.65 cm.  The mean percent collapse was 32 ± 20%.  Five patients had evidence of hypovolemia using guidelines from the American Society of Echocardiology; 6 patients had evidence of hypervolemia.  Nineteen patients had measurements between these 2 categories.  There is no significant change in mean diameters following fluid administration for 24 hours.  An initial IVC diameter of 0.94 cm predicted ≥ 30% collapsibility with an area under the curve is 0.748. Discussion: Patients with acute kidney injury based on laboratory measurements had evidence for hypovolemia, euvolemia, and hypervolemia based on IVC measurements.  There was no consistent change in IVC dimensions following fluid administration, even though the creatinine fell in most patients.  Simple bedside measurements of IVC dimensions can facilitate fluid administration decisions but must be used with clinical assessment.

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