Renal Replacement Therapies after Abdominal Aortic Aneurysm Repair – A Review

Autor: Narcis Hudorović, Ivo Lovričević, Petar Brkić, Zaky Ahel, Višnja Vičić-Hudorović
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Acta clinica Croatica
Volume 50
Issue 3
ISSN: 1333-9451
0353-9466
Popis: The objective of this review is to assess the incidence of postoperative acute renal failure that necessitates the application of hemofiltration and to determine the factors that influence the outcome in patients undergoing surgical repair of abdominal aortic aneurysm. In addition, the review aims to assess the outcomes of postoperative early hemofiltration as compared to late intensive hemofiltration. Different forms of renal replacement therapies for use in abdominal aortic aneurysm surgery patients are discussed. Electronic literature searches were performed using Pubmed, Medline, Embase, Sumsearch, Cinahil, The Cochrane Central Register of Controlled Trials and Excerpta Medica. The search identified 419 potentially eligible studies, of which 119 were excluded based on the title and abstract. Of the remaining 300 studies, full articles were collected and re-evaluated. Forty-five articles satisfied our inclusion criteria, of which only 12 were of the IA Level of evidence. The search results indicated that the underlying disease, its severity and stage, the etiology of acute renal failure, clinical and hemodynamic status of the patient, the resources available, and different costs of therapy might all influence the choice of the renal replacement therapy strategy. However, clear guidelines on renal replacement therapy duration are still lacking. Moreover, it is not known whether in acute renal failure patients undergoing abdominal aortic aneurysm surgery, renal replacement therapy modalities can eliminate significant amounts of clinically relevant inflammatory mediators. This review gives current information available in the literature on the possible mechanisms underlying acute renal failure and recent developments in continuous renal replacement treatment modalities.
Danas postoje brojni oblici zamjenske terapije u svrhu liječenja akutne bubrežne bolesti poslije kirurškog liječenja aneurizme abdominalne aorte. Cilj ovoga preglednog članka je utvrditi učestalost poslijeoperacijskog akutnog zatajenja bubrega koje iziskuje uporabu hemofiltracijskih postupaka te utvrditi čimbenike koji utječu na ishod liječenja bolesnika poslije kirurškog liječenja aneurizme abdominalne aorte. Stupanj težine združenih bolesti, etiologija akutne bubrežne bolesti, klinički i hemodinamski čimbenici bolesnika, veličina raspoloživih materijalnih sredstava, te troškovi terapije imaju izravan utjecaj na odabir i vrstu zamjenske terapije za liječenje akutne bubrežne bolesti. Postoje različita mišljenja o svrsishodnosti uporabe zamjenske terapije za liječenje akutne bubrežne bolesti. Nadalje, do danas su nedostatno opisane smjernice o potrebnom trajanju zamjenske terapije za liječenje akutne bubrežne bolesti. Nedostatno je razjašnjeno kakva je učinkovitost zamjenske bubrežne terapije kod hemodinamski nestabilnih bolesnika kod kojih nastaje akutna bubrežna bolest neposredno prije i poslije operacijskog zahvata. Također, nedostatno je poznavanje učinkovitosti mehanizama djelovanja zamjenskih bubrežnih terapija u smislu odstranjenja štetnih proizvoda metabolizma bubrega. U ovom preglednom članku opisuju se najnovija saznanja o mehanizmima i djelovanju te vrstama zamjenskih bubrežnih terapija koje su danas u uporabi kod bolesnika kod kojih se razvija akutna bubrežna bolest poslije kirurškog liječenja aneurizmatske bolesti abdominalne aorte.
Databáze: OpenAIRE
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