Document Detail

The effect of infrarenal aortic reconstruction on glomerular filtration rate and effective renal plasma flow.
MedLine Citation:
PMID:  1499737     Owner:  NLM     Status:  MEDLINE    
Compromised patients with aortic disease are vulnerable to various complications from aortic reconstruction. These complications are related to changes in systemic haemodynamics during aortic cross-clamping, which leads to cardiac stress and alteration in regional blood flow to different organs. One of the most important postoperative complications is renal failure which is associated with a high mortality rate. Circulatory alterations within the kidney must play a role in the pathogenesis of renal dysfunction that may follow infrarenal aortic cross-clamping and reconstruction. To study the effects of abdominal aortic reconstruction on renal function and perfusion, we measured prospectively the glomerular filtration rate (GFR, n = 59), effective renal plasma flow (ERPF, n = 38) and left ventricular ejection fraction (LVEF, n = 38) in patients undergoing elective infrarenal aortic reconstruction. Radionuclide techniques were used. The three parameters were measured at three time points: preoperatively, postoperatively and 6 months after surgery. The LVEF was measured in order to reflect the patient's cardiac status and pre-renal perfusion. We also measured the three parameters in two control groups of patients: a group of patients undergoing major colonic surgery and a group of patients with arterial disease under conservative management. Six months after surgery the GFR had decreased in 67% of aortic reconstruction patients. Overall GFR in the aortic reconstruction group decreased by a mean of 9 ml min-1 (p = 0.007). This was associated with a decrease in the ERPF in 48.5% of patients. The mean decrease in ERPF in the aortic reconstruction group was 74 ml min-1 (p = 0.05). The LVEF was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
R W Awad; W J Barham; D N Taylor; D A Woodward; B R Bullen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular surgery     Volume:  6     ISSN:  0950-821X     ISO Abbreviation:  Eur J Vasc Surg     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-09-16     Completed Date:  1992-09-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709440     Medline TA:  Eur J Vasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  362-7     Citation Subset:  IM    
Department of General Surgery, Walsgrave Hospital, Coventry, U.K.
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MeSH Terms
Aged, 80 and over
Aorta, Abdominal / physiopathology,  surgery
Aortic Aneurysm / physiopathology,  surgery*
Blood Flow Velocity / physiology
Cardiac Output / physiology
Colorectal Neoplasms / physiopathology,  surgery
Glomerular Filtration Rate / physiology*
Ischemia / physiopathology,  surgery*
Kidney / blood supply*
Leg / blood supply*
Middle Aged
Postoperative Complications / physiopathology*
Reference Values
Regional Blood Flow / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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