Can the patterns of acute renal dysfunction after reconstructive interventions for peripheral atherosclerosis be considered expectable?

Abstract

An original study was conducted and risk factors predisposing to the development of acute renal dysfunction (ARD) were identified, the frequency and consequences of ARD after revascularization operations on the lower extremities were established, and data from scientific articles on this topic were studied and summarized. The aim of the study was to investigate the circumstances of the risk of ARD in patients who underwent revascularization due to peripheral arterial disease.Material and methods. The signs of ARD development were prospectively studied in 101 patients operated on the aorto-iliac segment for peripheral atherosclerosis, including aneurysmal disease. Manifestations of ARD registered according to RIFLE recommendations were observed in 40 patients. Hemodynamic parameters, creatinine levels, diuresis, concomitant diseases, and the course of the postoperative period were analyzed.Results. The incidence of ARD was significantly higher in persons with diabetes mellitus, cardiac pathology and manifestations of generalized atherosclerosis, as well as after emergency interventions. The probability of ARD is especially high against the background of hemodynamic instability and blood loss of more than 1000 ml, including with manifestations of centralization of blood circulation.Conclusions. Massive blood loss with manifestations of hemodynamic instability, as well as cardiac disorders, has a decisive influence on the development of ARD after operations on the aorto-iliac segment.