1988
DOI: 10.1159/000167664
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Reversal of Renal Failure after Revascularization in Atheromatous Renovascular Disease

Abstract: We report 2 patients with severe renal failure and hypertension secondary to atherosclerotic renovascular disease who required hemodialysis. Successful surgical revascularization in these patients resulted in the recovery of renal function (twice in a patient) and in controlling the blood pressure. These results indicate that in the presence of severe renal artery obstruction renal parenchyma may be preserved, while renal function is absent. We highlight the usefulness of preoperative renal arteriography for e… Show more

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Cited by 5 publications
(7 citation statements)
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“…12 Prompt or even delayed revascularization may lead to complete or near complete recovery of renal function. 2,[4][5][6][7] It should be emphasized that after surgical or endovascular revascularization of ischemic nephropathy, up to 25% of patients experience improvement in renal function, 50% of patients have stabilization and up to 25% of patients note a deterioration of renal function. [13][14][15][16] Deterioration in renal function can be abrupt and progressive.…”
Section: Discussionmentioning
confidence: 99%
“…12 Prompt or even delayed revascularization may lead to complete or near complete recovery of renal function. 2,[4][5][6][7] It should be emphasized that after surgical or endovascular revascularization of ischemic nephropathy, up to 25% of patients experience improvement in renal function, 50% of patients have stabilization and up to 25% of patients note a deterioration of renal function. [13][14][15][16] Deterioration in renal function can be abrupt and progressive.…”
Section: Discussionmentioning
confidence: 99%
“…Some preoperative markers are useful in predicting cases in which retrieval of renal function is achievable : kidney size of at least 9 cm length, 2,5-7,14,16-18 residual isotopic glomerular filtration, 7 disease-free distal renal artery 3,7,16,17 on late angiogram or evidenced by echo-Duplex, or renal biopsy. 2,3,5,13 Kidney size and a patent renal artery beyond the main stem occlusion are the most reliable predictors. Isotopic function tests lose much sensitivity in poorly perfused kidneys and intraoperative biopsy is questionable since it offers focal information and will be normal if other criteria are met.…”
Section: Discussionmentioning
confidence: 99%
“…The critical hypoperfusion at subfiltration pressure by way of capsular collaterals is sufficient to preserve viability of the glomeruli, even for prolonged periods, but is inadequate to ensure renal excretory function. 5,[8][9][10]22 This has been experimentally demonstrated by Morris et al 23 Perfusion pressures as low as 20 mmHg offer protection from parenchymatal anoxic injury but are suboptimal for urine production. The renal tubuli are more prone to ischaemic lesions, but also have a marked regenerative potential once normal kidney perfusion is restored.…”
Section: Discussionmentioning
confidence: 99%
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“…By the end of the 1980s it was clear that ARAS could progress to renal artery occlusion, which usually resulted in failure and shrinkage of the kidney, often without symptoms of renal infarction. Occlusion of the artery to a solitary functioning kidney produced complete renal failure, but such kidneys could sometimes be salvaged by intervention (6, 7). One of the advocates of this procedure noted in 1989 that “patients with ESRD and ARAS without complete occlusion are not appropriate candidates for revascularization to restore renal function”(8).…”
mentioning
confidence: 99%