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Sol Renal Arter Stenozu ve Sağda Atroflk Böbrek Olan Hastada Son Dönem Böbrek Yetmezliğinin Stent ile Önlenmesi

End Stage Renal Disease Prevention by Stent Implantation in Patient With Left Renal Artery Stenosis and Right Atrophic Kidney

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Renovascular disease is an important cause of secondary hypertension. End-stage renal disease (ESRD) due to bilateral renal artery stenosis or ischemic renal disease is an increasingly recognized and potentially reversible disorder. It has been reported that ischemic renal disease may be responsible for 5-22% of patients with advanced renal failure, who are over the age of 50. A 73-year-old female was admitted to our clinic with the complaints of ESRD, for the administration of replacement treatment. She was on hemodialysis program for two weeks. Initial physical examination revealed a blood pressure of 165/110 mmHg. In her Doppler ultrasonography, right kidney atrophy, hypoplasia of renal artery, normal size of left kidney and in aortic outlet of renal artery 300 cm/sec systolic peak f l ow consistent with about 90% stenosis was seen. A stenosis of greater than 90% was confirmed with selective angiography and a stent was implanted to the left renal artery. Afterwards, the f l ow of the left renal artery was observed normally. Urine output was found to be increased and need for dialysis decreased and finally the patient was free from the chronic dialysis program. It must be emphasized that renal artery stenosis should be i n vestigated by invasive or noninvasive methods in suspected patients with ESRD to confirm the diagnosis. Even in elderly patients, to reverse renal function, invasive procedures must be performed to reverse renal artery stenosis.
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Abstract (Original Language): 
Renovasküler hastalıklar sekoncler hipertansiyon nedenleri arasında çok önemli bir yer tutar. Bilateral-ünilateral renal arter stenozu ya da iskemik renal hastalık nedeniyle gelişen son dönem böbrek hastalığı (SDBH) artan oranda tanımlanmaktadır ve potansiyel olarak geri dönüşlüdür. Elli yaş üzerindeki iskemik nedenli ileri derece böbrek yetmezliği olan hastaların %5-22'si tedaviye cevap verir. Yetmiş üç yaşındaki kadın hasla, SDBH tanısı ile renal replasman tedavisinin düzenlenmesi için kliniğe kabul edildi. Hastaya 2 haftadır hemodiyaliz yapılıyordu. Fizik incelemede, kan basıncı 165/110 mmHg ölçüldü. Doppler ultrasonografıde, sağ böbrek atrofik ve renal arter hipoplazik, sol böbrek normal boyutlarda ve renal arterin aort yıkımında %90 darlık lehine 300 cm/sn'ye varan doruk sistolik hız görülmekteydi. Selektif anjiyografide %90 üzerinde darlık olduğu doğrulandı ve sol renal artere stent yerleştirildi. İşlem sonrasında sol renal arter akımının normal olduğu gözlendi. Takiplerde idrar miktarı artan, kreatinin değerleri normale gelen hastanın diyaliz ihtiyacının olmadığı gözlendi. Son dönem böbrek hastalığı olan hastalarda, etiyolojik nedenin renal arter stenozu olduğu düşünülüyorsa, invazif ve noninvazif tanı yöntemleri kullanılarak tanı doğrulanmalıdır. Yaşlı hastalarda bile renal fonksiyonların geri döndürülmesi için mutlaka girişimsel işlemler yapılıp renal arter stenozu düzeltilmelidir.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_16_pp_147-150.pdf
  • 3
147-150
  • Turkish

REFERENCES

References: 

i Greco HA. BreyerJA,
Atherosclerotic ischemic renal disease.
Anı J kidney Dis I997;29:l< ~. 2. Sulum Kİ). Ti'Mor SC. Renal anerj stenosis. N Engl J Med
2000,344:43i-1
12
, 3 Rimmer.IM. Gennari Ij, Atherosclerotic renovascular disease
antl
progressiv
e renal failure. Ann Intern Med 1993;11&712. ı, Stable JE, llamillon G. Atherosclerotic renovascular disease.
Remediable eau.se I'm- renal failine in rite elderly. HMJ 1990;
501X67 111:1670-1. 5» Van AmptingJM, penne EL, Beek I'l, kmmians HA. Prevalan-
ce of atherosclerotic renal artery stenosis in patients starting dialysis. Nephrol Dial Transplant 2003; 18:1147.
(->. AlcazarJM, Radicio |L Ischemic nehpropathy: clinical charac¬teristics and treatment. Anı j Kidney Dis 2000:36:883.
7. Olin JW, Melia M, Young JR, et al. Prevalance of atherosclerotic renal artery stenosis in patients with atherosclerosis elsewhere. Am J Med 1990;88:46.
H. Detection, evaluation, and ireatnient of renovascular hypcr-tension. Final report. Working Group on Renovascular Hypertension. Arch Intern Med 1987;l47(5):820-9.
9. Derkx EH, Schaiekamp MA. Renal artery stenosis and hypertension. Lancet 1994;344{H917):237-9.
10. Davis BA, Crook JR. Vestal RE, Oakes JA. Prevalence of renovascular hypertension in patients wilh grade ill or IN' retinopathy. N Engl J Med 1979;30H23M 273-6.
11. Van de, Ven PJ, Bentler JJ, Kaatee R, beek FJ. Angiotensin converting enzyme inhibitor-induced renal dysfunction in aterosclerotic renovascular disease. Kidney int 1998;53(4): 986-93.
12. Gondhi SK, Powers JC, Nomeir AN et al. The pathogenesis of acute pulmonary edema associated with hypertension. N Eng j Med 2001 ;344U): 17-22.
13. Fatica RA, Port FK, Young EW. Incidence trends and mortality in end-stage renal disease attributed to renovascular disease in the United States. Am J Kidney Dis 2001; 37(6): 1184-90.
14. Tullis MJ, Caps MT, Zierler RE et al. Blood pressure, antihypertensive medieation. and atherosclerotic renal artery stenosis. Am J Kidney Dis 1999:33:675.
15. l'louin PF. Stable patients with atherosclerotic renal artery stenosis should be Heated first with medical management. Am J Kidney Dis 2003:42:851-857.
16. Van Jaarsveld BC, Krijnen P, Pieterman H. et al. The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group. N Bog) J Med 2000-,342:1007-1014.
17. OlinJW, Piedmonte MR, Young JR, et al. The utility of duple^ ultrasound scanning of the renal arteries lor diagnosing significant renal artery stenosis. Ann Intern Med 1995:122:833-
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