Anuric acute renal failure and pulmonary oedema: A case for urgent action

Chrysochou, Constantina; Sinha, Smeeta; Chalmers, Nicholas; Kalra, Paul R.; Kalra, Philip A.

doi:10.1016/j.ijcard.2007.07.121

Cited by 28 publications

(17 citation statements)

References 9 publications

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“…This renal recovery can be obtained by intervention even after extended periods with severe renal dysfunction and anuria. This has been reported previously 4,5 up to 6 days, but to our knowledge this is the first report of renal recovery after 1 month of renal failure with anuria.…”

Section: Case Reportsupporting

confidence: 67%

Resolution of Renal Failure 1 Month After Onset through Angioplasty of Renal Artery Stenosis

et al. 2011

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Section: Case Reportsupporting

confidence: 67%

Resolution of Renal Failure 1 Month After Onset through Angioplasty of Renal Artery Stenosis

et al. 2011

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“…Angioplasty with stent insertion, or primary stenting, is preferred to angioplasty alone due to better arterial patency and markedly lower restenosis rates in atherosclerotic ostial RAS [12,13], but the use of drug-eluting [14] devices has not been found to provide any additional advantage [15]. There is general consensus, but no evidence base, that renal revascularization should be performed in patients with anatomically significant RAS who present with particular clinical scenarios such as life-threatening, sudden onset or ‘flash’ pulmonary oedema [16], or oligo-anuric acute kidney injury (AKI) [17]. Other clinicians would feel that ARVD patients with multidrug-resistant renovascular hypertension and those with steadily deteriorating renal function should undergo revascularization procedures.…”

Section: Renal Revascularization In Arvdmentioning

confidence: 99%

Current Management of Atherosclerotic Renovascular Disease – What Have We Learned from ASTRAL?

Chrysochou

Kalra

2010

Nephron Clin Pract

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With an increasingly ageing and atherosclerotic-prone population, clinical encounters with patients with atheromatous renovascular disease (ARVD) are commonplace. ARVD is frequently associated with chronic kidney disease (CKD) and hypertension, but evidence suggests that causality only occurs in the minority and it is likely that many atherosclerotic renal artery stenosis (RAS) lesions are incidental. Its association with extensive cardiovascular co-morbidity predisposes to a high patient mortality. The availability of renal angioplasty and stenting, which are generally safe techniques for dilating RAS lesions, has led to widespread use of these endovascular therapies in ARVD, but the outcomes after treatment have been inconsistent, with no clear evidence of benefit in many patients. There has been a great need for a large and appropriately powered randomised control trial to help guide clinical practice. In this review, we present an interpretation of the results of the recently reported Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) trial as well as a brief review of the latest literature, so as to provide the latest guidance regarding the management of this common condition.

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“…In the context of chronic ARVD, modest AKI typically develops where an acute insult reduces perfusion pressure in the renal circulation to the point where parenchymal viability is compromised. Anuric presentations are limited to scenarios in which there is acute vascular occlusion preceding collateral development [ 85 ]. This is typically in the context of high-grade bilateral disease, or stenosis of a single functioning kidney, and such patients would be at increased risk of fl ash pulmonary edema.…”

Section: Acute Kidney Injury (Aki)mentioning

confidence: 99%