Can the patterns of acute renal dysfunction after reconstructive interventions for peripheral atherosclerosis be considered expectable?
https://doi.org/10.18699/SSMJ20230308
Abstract
An original study was conducted and risk factors predisposing to the development of acute renal dysfunction (ARD) were identified, the frequency and consequences of ARD after revascularization operations on the lower extremities were established, and data from scientific articles on this topic were studied and summarized. The aim of the study was to investigate the circumstances of the risk of ARD in patients who underwent revascularization due to peripheral arterial disease.
Material and methods. The signs of ARD development were prospectively studied in 101 patients operated on the aorto-iliac segment for peripheral atherosclerosis, including aneurysmal disease. Manifestations of ARD registered according to RIFLE recommendations were observed in 40 patients. Hemodynamic parameters, creatinine levels, diuresis, concomitant diseases, and the course of the postoperative period were analyzed.
Results. The incidence of ARD was significantly higher in persons with diabetes mellitus, cardiac pathology and manifestations of generalized atherosclerosis, as well as after emergency interventions. The probability of ARD is especially high against the background of hemodynamic instability and blood loss of more than 1000 ml, including with manifestations of centralization of blood circulation.
Conclusions. Massive blood loss with manifestations of hemodynamic instability, as well as cardiac disorders, has a decisive influence on the development of ARD after operations on the aorto-iliac segment.
About the Authors
N. I. GlushkovRussian Federation
Nikolay I. Glushkov, doctor of medical sciences, professor
195067, Saint-Petersburg, Piskarevsky ave., 47
I. A. Kostyle
Russian Federation
Igor A. Kostylev
195067, Saint-Petersburg, Piskarevsky ave., 47
M. D. Naidenova
Russian Federation
Maria D. Naidenova
195067, Saint-Petersburg, Piskarevsky ave., 47
A. A. Borodich
Russian Federation
Aleksandr A. Borodich
195067, Saint-Petersburg, Piskarevsky ave., 47
M. A. Troyno
Russian Federation
Maria A. Troyno
195067, Saint-Petersburg, Piskarevsky ave., 47
A. V. Novik
Russian Federation
Anna V. Novik
195067, Saint-Petersburg, Piskarevsky ave., 47
L. S. Bakhtigareeva
Russian Federation
Lia S. Bakhtigareeva
195067, Saint-Petersburg, Piskarevsky ave., 47
M. A. Ivanov
Russian Federation
Mikhael A. Ivanov, doctor of medical sciences, professor
195067, Saint-Petersburg, Piskarevsky ave., 47
References
1. Hobson C., Lysak N., Huber M., Scali S., Bihorac A. Epidemiology, outcomes, and management of acute kidney injury in the vascular surgery patient. J. Vasc. Surg. 2018;68(3):916–928. doi: 10.1016/j.jvs.2018.05.017
2. Ivanov M.A., Kasimova A.M., Chizhova K.A. Prevention of kidney damage during operations for peripheral atherosclerosis. Preventive medicine-2020: proc. conf., Saint-Petersburg, November 18–19, 2020. Part 1. Saint-Petersburg: Publishing House of I.I. Mechnikov NWSMU, 2020. P. 163–168. [In Russian].
3. Safley D.M., Salisbury A.C., Tsai T.T., Secemsky E.A., Kennedy K.F., Rogers R.K., Latif F., Shammas N.W., Garcia L., Cavender M.A., … Spertus J.A. Acute kidney injury following in-patient lower extremity vascular intervention: from the National Cardiovascular Data Registry. JACC Cardiovasc. Interv. 2021;14(3): 333–341. doi: 10.1016/j.jcin.2020.10.028
4. Lieberthal W., Nigam S.K. Acute renal failure. II. Experimental models of acute renal failure: imperfect but indispensable. Am. J. Physiol. Renal. Physiol. 2018;278(1):F1-F12. doi: 10.1152/ajprenal.2000.278.1.F1
5. Pathak S., Olivieri G., Mohamed W., Abbasciano R., Roman M., Tomassini S., Lai F., Wozniak M., Murphy G.J. Pharmacological interventions for the prevention of renal injury in surgical patients: a systematic literature review and meta-analysis. Br. J. Anaesth. 2021;126(1):131–138. doi: 10.1016/j.bja.2020.06.064
6. Er R.E., Okyay G.U., Kmaz G.A.B., Lu M.T., Erten Y. Comparison between RIFLE, AKIN, and KDIGO: acute kidney injury definition criteria for prediction of in-hospital mortality in critically ill patients. Iran. J. Kidney Dis. 2020;14(5):365–372.
7. Sarnak M.J., Amann K., Bangalore S., Cavalcante J.L., Charytan D.M., Craig J.C., Gill J.S., Hlatky M.A., Jardine A.G., Landmesser U., … Conference Participants. Chronic kidney disease and coronary artery disease: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2019;74(14):1823–1838. doi: 10.1016/j.jacc.2019.08.1017
8. Glushkov N.I., Ivanov M.A., Samko K.V., Puzdriak P.D., Bondarenko P.B., Zhdanovich K.V., Petrova K.A., Kolchinsky I.A., Ponikarova N.Yu. Abdominal aorta surgical intervention and acute renal injury. Vestnik khirurgii imeni Ivana Ivanovicha Grekova = Grekov’s Bulletin of Surgery. 2020;179(2):20–25. [In Russian]. doi: 10.24884/0042-4625-2020-179-2-20-25
9. Gameiro J., Fonseca J.A., Outerelo C., Lopes J.A. Acute kidney injury: from diagnosis to prevention and treatment strategies. J. Clin. Med. 2020;9(6):1704. doi: 10.3390/jcm9061704
10. Romagnoli S., Ricci Z., Ronco C. Perioperative acute kidney injury: prevention, early recognition, and supportive measures. Nephron. 2018;140(2):105–110. doi: 10.1159/000490500
11. Nonaka T., Kimura N., Hori D., Sasabuchi Y., Nakano M., Yuri K., Sanui M., Matsumoto H., Yamaguchi A. Predictors of acute kidney injury following elective open and endovascular aortic repair for abdominal aortic aneurysm. Ann. Vasc. Dis. 2018;11(3):298–305. doi: 10.3400/avd.oa.18-00029
12. Tsilimigras D.I., Sigala F., Karaolanis G., Ntanasis-Stathopoulos I., Spartalis E., Spartalis M., Patelis N., Papalampros A., Long C., Moris D. Cytokines as biomarkers of inflammatory response after open versus endovascular repair of abdominal aortic aneurysms: a systematic review. Acta Pharmacol. Sin. 2018;39(7):1164–1175. doi: 10.1038/aps.2017.212
13. Smidfelt K., Nordanstig J., Wingren U., Bergström G., Langenskiöld M. Routine open abdomen treatment compared with on-demand open abdomen or direct closure following open repair of ruptured abdominal aortic aneurysms: A propensity score-matched study. SAGE Open Med. 2019;7:2050312119833501. doi: 10.1177/2050312119833501
Review
For citations:
Glushkov N.I., Kostyle I.A., Naidenova M.D., Borodich A.A., Troyno M.A., Novik A.V., Bakhtigareeva L.S., Ivanov M.A. Can the patterns of acute renal dysfunction after reconstructive interventions for peripheral atherosclerosis be considered expectable? Сибирский научный медицинский журнал. 2023;43(3):69-74. (In Russ.) https://doi.org/10.18699/SSMJ20230308