Optimization of the treatment of patients with atherosclerotic lesions of the abdominal aorta with atherosclerosis of the renal arteries

October 7, 2022
983
Specialities :
Resume

Purpose: to optimize the surgical treatment of atherosclerotic lesions of the abdominal aorta with combined atherosclerosis of the renal arteries.

Object and research methods. The frequency of development and severity of acute postoperative kidney damage (APKD) was determined in 185 patients after abdominal aortic aneurysm resection and aorto-bifemoral shunting with occlusive damage of the terminal aorta and iliac arteries. APKD was determined by the RIFLE scale.

Results. The risk of developing APKD was established before surgery in 23% of patients with abdominal aortic aneurysm and occlusive-stenotic lesions of the terminal aorta and iliac arte­ries. In the postoperative period, the degree I was found in 20%, F — in 7% of patients.

Conclusion. Determining the risk of developing APKD in the preoperative period using the optimized RIFLE score is an important and necessary prerequisite.

References

  • 1. Brienza N., Giglio M.T., Marucci M., Fiore T. (2009) Does perioperative hemodynamic optimization protect renal function in surgical patients? A meta-analytic study. Crit. Care Med., 37(6): 2079–2090. doi: 10.1097/CCM.0b013e3181a00a43.
  • 2. Chertow G.M., Burdick E., Honour M. et al. (2005) Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J. Am. Soc. Nephrol., 16(11): 3365–3370. doi: 10.1681/ASN.2004090740.
  • 3. Hudson C., Hudson J., Swaminathan M., Shaw A. (2008) Emerging concepts in acute kidney injury following cardiac surgery. Semin. Cardiothorac. Vasc. Anesth., 12(4): 320–330. doi: 10.1177/1089253208328582.
  • 4. Иванов Д.Д. (2012) Острое повреждение почек. Мед. неотл. сост., 3(42): 16–19.
  • 5. Миронов П.И. (2009) Острое повреждение почек у пациентов отделений интенсивной терапии: проблемы, дефиниции, оценка тяжести и прогноза. Новости анестезии и реанимации, 2: 3–16.
  • 6. Desai M., Gill I.S., Ramani A.P. et al. (2005) The impact of warm ischaemia on renal function after laparoscopic partial nephrectomy. BJU Int., 95(3): 377–383.
  • 7. Thompson R.H., Frank I., Lohse C.M. et al. (2007) The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multiinstitutional study. J. Urol., 177(2): 471–476. doi: 10.1016/j.juro.2006.09.036.
  • 8. Серегин А.В., Шустицкий Н.А. (2012) Органосохраняющие операции при раке почки: особенности хирургической техники. Consilium medicum, 2: 45–49.
  • 9. Школьник М.И. (2009) Современные методы гемостаза при органосохраняющих операциях по поводу рака почки. Онкохирургия, 1: 32–35.
  • 10. Wagener G., Brentjens T.E. (2010) Anesthetic concerns in patients presenting with renal failure. Anesthesiology Clin., 28(1): 39–54. doi: 10.1016/j.anclin.2010.01.006.
  • 11. Cockroft D.W., Gault M.H. (1976) Prediction of creatinine clearance from serum creatinine. Nephrol., 16(1): 31–41. doi: 10.1159/000180580.