Aortic clamping during elective operations for infrarenal disease: The influence of clamping time on renal function

Wahlberg, Eric; DiMuzio, Paul; Stoney, Ronald J.

doi:10.1067/mva.2002.123679

Cited by 139 publications

(86 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…During cardiac intervention, ischemic renal injury can occur during operative procedures and with the use of contrast media, anesthetics, antibiotics, and diuretics; these are considered risk factors for renal impairment. 16,17 Our previous study of patients with stroke or aneurysm found that 10.4-12% had RAS and impaired kidney function was associated with its presence. 18,19 RAS is an important predictor of kidney function; however, kidney dysfunction is not totally attributable to the presence of RAS.…”

Section: Discussionmentioning

confidence: 99%

Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction

et al. 2011

View full text Add to dashboard Cite

Objectives: Chronic kidney disease (CKD) is a major risk factor for cardiovascular disease (CVD). We previously reported renal parenchymal damage in autopsy subjects with stroke or abdominal aortic aneurysm. The aim of this study is to evaluate the relationship between renal histology and clinical characteristics of patients with myocardial infarction (MI). Methods: A total of 699 subjects were autopsied at the National Cerebral and Cardiovascular Center Hospital. We retrospectively evaluated all autopsy cases with MI (n = 123). Estimated glomerular filtration rate (eGFR) was calculated using the Japanese formula. Subjects were classified into four groups: 25 subjects with eGFR ≥ 60 mL/min/1.73 m 2 and no proteinuria (no CKD), 10 subjects with eGFR ≥ 60 and proteinuria (CKD1/2), 65 subjects with 60 > eGFR ≥ 30 (CKD3), and 23 subjects with eGFR < 30 (CKD4/5). Renal parenchymal damage was evaluated using a semi-quantitative histological score (score 0-3) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, arteriolar hyalinosis, and arteriosclerosis of medium-sized artery (maximum score = 15). Results: The mean histological score was significantly higher in patients with CKD3 and CKD4/5 and was associated with age, hypertension, diabetes, kidney function, proteinuria, and other CVD. Conclusions: In patients with MI, renal parenchymal damage and deteriorating kidney function are closely associated.

show abstract

Section: Discussionmentioning

confidence: 99%

Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[3][4][5][12][13][14] Other studies have reported poor renal function with such prolonged ischemia times. 14,15 It would seem that kidneys with tumours amenable to partial nephrectomy may not be subjected to the same global stress as kidneys with major trauma or physiologic events surrounding the death of cadaveric kidney donors and hence may tolerate longer WIT.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 However, reports show renal function recovery at WIT of 45 to 271 minutes. [3][4][5][6] As advances in laparoscopic surgery continue to evolve, minimally invasive surgical techniques are being applied to increasingly complex surgical procedures. One of the limitations for laparoscopic partial nephrectomy has been the duration of renal hilar clamp time required to remove the tumour, secure hemostasis and repair the collecting system by intracorporal suturing, which may easily take more than 30 minutes.…”

Section: Introductionmentioning

confidence: 99%

Renal histopathology features according to various warm ischemiatimes in porcine laparoscopic and open surgery model

Sabbagh

Chawla

Tisdale

et al. 2013

CUAJ

View full text Add to dashboard Cite

Background: Thirty minutes has been considered as the threshold for tolerable warm ischemic time (WIT). Recent reports demonstrate recovery of renal function after longer WIT. We assessed renal histology according to different WIT in a 2-kidney porcine model. Methods: Twelve female pigs were randomized to an open or laparoscopic group. Each pig was further randomized within each group to clamping the left renal artery for 5, 15, 30, 45, 60 or 180 minutes. Preclamping left renal biopsies were performed on each pig. The contralateral kidney in each animal was used as an individual control. On postoperative day 14, all animals underwent bilateral nephrectomies. Preclamping left renal biopsies and all renal specimens were evaluated by a blinded veterinary pathologist. Results: One pig died in the open group after 180 minutes of clamping. Histopathology did not show any significant changes between the two groups and across clamp times from 5 to 60 minutes. After 180 minutes of laparoscopic clamping, there was evidence of diffuse necrosis. Interpretation: Sixty minutes of ischemia did not show any permanent renal damage in both groups. Further studies are needed to verify these findings in humans. A prolonged ischemic time without permanent renal damage would be helpful in partial nephrectomy. Warm ischemic time of 180 minutes exceeded the renal ischemic burden based on histological features.

show abstract

“…E. Wahlberg и соавт. [16] подчеркнули, что наиболее важ-ным фактором риска ишемического повреждения являет-ся продолжительность пережатия аорты проксимальнее почечного трансплантата. Они пришли к выводу, что пе-режатие аорты менее 50 мин является безопасным, но на-рушения функции почки в предоперационном периоде и гипотензия во время операции могут привести к ишеми-ческим повреждениям даже при кратковременной ише-мии.…”

Section: заключениеunclassified

Simultaneous abdominal aortic replacement and cholecystectomy in patient with aortic aneurysm and transplanted kidney

Belov¹,

Charchyan²,

Stepanenko³

et al. 2016

Kardiol. serdechno-sosud. khir.

View full text Add to dashboard Cite

Aortic clamping during elective operations for infrarenal disease: The influence of clamping time on renal function

Cited by 139 publications

References 19 publications

Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction

Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction

Renal histopathology features according to various warm ischemiatimes in porcine laparoscopic and open surgery model

Simultaneous abdominal aortic replacement and cholecystectomy in patient with aortic aneurysm and transplanted kidney

Contact Info

Product

Resources

About