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Diyalize Giren Kronik Renal Yetmezlikli Olguda Bir Renal Arter Stenozunun Tespiti ve Tedavisi ile Diyalizin Sonlandırılması

Termination of Dialysis in a Patient With Chronic Renal Failure After the Detection and Treatment of Renal Artery Stenosis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Chronic renal failure (CRF) 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 44-year-old man was admitted to our clinic with the complaints of disorientation. He had hypertension since three years. Ininitial physical examination revealed a blood pressure of 190/115 mmHg. On magnetic resonance imaging, there was an appearance which was suitable with stenosis aproximately 1 cm in a distance from the exit level of left renal artery from aorta. A stenosis of greater than 90% was confirmed with selective angiography and a stent was implanted to the left renal artery. Afterwards, the flow 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 discarged from the chronic dialysis program. It must be emphasized that renal artery stenosis should be inves¬ tigated in highly suspected patients even though they were in the late end stage renal disease. Furthermore, invasive procedures should be performed for the aim of revascularization.
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Abstract (Original Language): 
Bilateral renal arter stenozu ya da iskemik renal hastalık nedeniyle gelişen kronik böbrek yetmezliği artan oranda tanımlanmakta olup potansiyel olarak da geri dönüşlüdür. Elli yaş üzerindeki iskemik nedenli ileri derece böbrek yetmezliği olan hastaların %5-22'si tedaviye cevap verir. Kırk dört yaşında erkek hasta, bilinç kaybı nedeniyle kliniğe kabul edildi. Anamnezde 3 yıldır hipertansiyonu vardı. Son 3 aydır takipsiz olduğu öğrenildi. Fizik incelemede, kan basıncı 190/115 mmHg ölçüldü. Klinik ve laboratuvar bulgular ile malign hipertansiyon olabileceği düşünülen hastaya ileri inceleme yapıldı. Manyetik rezonans anjiyografide sol renal arterin aortadan çıkış seviyesinden yaklaşık 1 cm uzaklıkta daralma ile uyumlu görünüm vardı. Selektif anjiyografide %90 üzerinde darlık olduğu doğrulandı ve sol renal artere stent yer¬ leştirildi. işlem sonrasında sol renal arter akımının normal olduğu gözlendi. Takiplerde idrar miktarı artan ve serum üre, kreatinin de¬ ğerlerinde gerileme olan hastanın diyaliz ihtiyacının olmadığı göz¬ lendi. Son dönem böbrek yetmezliği olan hastalarda etiyolojik nedenin renal arter stenozu olduğu düşünülüyorsa ve geç tespit edilse dahi renal fonksiyonların tekrar geri döndürülmesi için mutlaka girişimsel işlemler yapılıp renal arter stenozu düzeltilmelidir.
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  • 2
119-121
  • Turkish

REFERENCES

References: 

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