29 research outputs found
Π Π°ΡΡΠ΅Ρ Π±ΠΎΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΌΠ°Π³Π½ΠΈΡΠ½ΠΎΠ³ΠΎ ΡΠΎΠΏΡΠΎΡΠΈΠ²Π»Π΅Π½ΠΈΡ ΡΠ»Π΅ΠΊΡΡΠΎΠΌΠ°Π³Π½ΠΈΡΠ½ΡΡ ΠΌΠΎΠ»ΠΎΡΠΊΠΎΠ²
Hemolysis is an inevitable side effect of cardiopulmonary bypass resulting in increased plasma free hemoglobin that may impair tissue perfusion by scavenging nitric oxide. Acute kidney injury after on-pump cardiovascular surgery arises from a number of causes and severely affects patient morbidity and mortality. Here, we studied the effect of acute hemolysis on renal injury in 35 patients undergoing on-pump surgical repair of thoracic and thoracoabdominal aortic aneurysms of whom 19 experienced acute kidney injury. During surgery, plasma free hemoglobin increased, as did urinary excretion of the tubular injury marker N-acetyl-Ξ²-D-glucosaminidase, in patients with and without acute kidney injury, reaching peak levels at 2 h and 15 min, respectively, after reperfusion. Furthermore, plasma free hemoglobin was independently and significantly correlated with the urine biomarker, which, in turn, was independently and significantly associated with the later postoperative increase in serum creatinine. Importantly, peak plasma free hemoglobin and urine N-acetyl-Ξ²-D-glucosaminidase concentrations had significant predictive value for postoperative acute kidney injury. Thus, we found an association between increased plasma free hemoglobin and renal injury casting new light on the pathophysiology of acute kidney injury. Therefore, free hemoglobin is a new therapeutic target to improve clinical outcome after on-pump cardiovascular surgery
Arteriovenous Fistulas Created with the Help of Personalised Blood Flow Simulations:Clinical Outcomes of a Randomised Controlled Trial
Loss of kidney function in patients with critical limb ischemia treated endovascularly or surgically
Radiation Exposure during Percutaneous Transluminal Angioplasty for Symptomatic Peripheral Arterial Disease
Acute hemolysis in surgical patients is independently associated with renal tubular damage and predicts acute kidney injury
Flap Fixation Using Tissue Glue or Sutures Appears to Reduce Seroma Aspiration After Mastectomy for Breast Cancer
The Effect of Geometric Graft Modification on Arteriovenous Graft Patency in Haemodialysis Patients:A Systematic Review and Meta-Analysis
Loss of Kidney Function after Endovascular Treatment of Peripheral Arterial Disease
Background: Administration of radiocontrast during endovascular procedures for peripheral arterial disease (PAD) may cause acute kidney injury, which generally recovers with supportive treatment. Long-term effects of endovascular procedures on renal function remain to be investigated. Method: This retrospective observational cohort study includes all patients who newly presented to the vascular surgery outpatient clinic with Rutherford class II or III PAD and who were treated with either supervised exercise therapy or endovascular interventions. Changes in estimated glomerular filtration rates (eGFR) after 1 year were compared between the 2 treatment groups. Multivariate regression analysis and propensity score matched paired analysis were done to correct for potential confounders. Results: One year after treatment, eGFR was reduced by 8.6 mL/min (95% confidence interval [CI], 7.3-9.9, P <0.001) after endovascular intervention (n = 284) and by 1.7 mL/min (95% CI, 0.9-25, P <0.001) after supervised exercise therapy (n = 299). After correction for potential confounders, endovascular interventions were associated with 9.2 mL/min (95% CI, 5.9-12.4, P <0.001) more renal decline compared to exercise therapy. Similar results were found in the propensity score matched paired analysis. Conclusions: Endovascular procedures for PAD are associated with clinically relevant and long-term loss of kidney function