Short-term Arterial Blood Reperfusion of Normothermic Kidney in Renal Artery and Abdominal Aorta Reconstructive Surgery

Abstract

the results of this study indicate that kidney short-term reperfusion may protect renal tissue from prolonged cross-clamping ischaemia (up to 100 min), also in patients considered at high risk for acute renal failure.

Endovascular Aortic Repair: The Renal Side of the Story

“…Moreover, in our studies, we included only patients without severe preoperative renal failure, which represents a known risk factor for renal postoperative renal complications. In a first pilot study in which we analyzed 47 consecutive patients undergoing EVAR with TRF, GFR impairment was documented at RPS in the 10.6% of cases [24], but there was no significant difference in postoperative GFR between IRF and TRF.…”

“…In these cases, a valid alternative consists in temporary renal reperfusion. In fact, in a previous study [24], we demonstrated that the temporary restoration of renal arterial inflow through a Pruitt-Inahara shunt for 3 min after 30 min of cross-clamping ischemia, protected from postoperative renal failure in juxtarenal aortic surgery, is also considered in patients at high risk for acute renal failure. Another important cause of ARF in aortic surgery is renal atheroembolism.…”

“…These methods of GFR estimation based on P Cr (or S Cr , serum creatinine) have the advantage to be simple and readily available in all clinical settings but are limited in that they represent only an estimation of the true GFR that may depend on several other factors such as weight, muscle body mass, sex, age, and comorbidities. Furthermore, P Cr results in a relatively lowsensitive diagnostic tool, since large changes on renal function must occur before a significant increase of P Cr , and, even if CrCl allows a more accurate evaluation of the glomerular filtration rate, this may be overestimated because of a variable tubular secretion of creatinine [23][24][25]. Another critical point is that C Cr does not allow a renal function determination separately for each kidney, which may be useful, especially in a clinical research scenario.…”

The Role of Vaccinium Myrtillus in the Prevention of Renal Injury in an Experimental Model of Ruptured Abdominal Aortic Aneurysm

“…Acute kidney injury occurring in association with perfusion disorder deriving from hemorrhagic shock and I/R in the surgical treatment of RAAA and intensive care follow-up is a significant clinical problem that can result in high mortality rates [6,10,22] . Deriu et al [22] reported that short-term reperfusion can protect the right and left renal arteries against acute kidney injury developing in association with abdominal aortic aneurysm [22] . Studies have also reported that abdominal aortic aneurysm can result in acute kidney injury by causing the production of free oxygen radicals [23] .…”

Effects of Intrarenal Administration of the Cox-2 Inhibitor Parecoxib During Porcine Suprarenal Aortic Cross-Clamping

“…Although some clinical studies tried to establish an effective local renoprotective management (bypass, shunt with blood, perfusion with cold lactated Ringer's solution, local cooling, etc.) (3)(4)(5)(6)(7)(8), there is still no widely accepted method for preventing renal failure. The idea of influencing ischemia reperfusion impact using cytoprotective agents is object of current investigations (9)(10)(11)(12).…”