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  • Title: [Kidney involvement in acute occlusion of the bifurcation of the aorta and the major arteries of the lower extremities].
    Author: Ivashchenko VV.
    Journal: Urol Nefrol (Mosk); 1990; (3):30-5. PubMed ID: 2396338.
    Abstract:
    A total of 162 patients with acute thromboses and embolism of bifurcation of the aorta and the major vessels of the extremities were studied for renal performance before and after the corrective surgery. In this line the values of central hemodynamics, electrolytic balance, acid-base composition of blood and the hemostatic system were investigated. The author established the relation between the renal dysfunction and the character of the underlying disease which was the cause of thromboses or embolism, the level of occlusion and the degree of ischemic lesions in the extremity mainly. It was revealed that in case of an increase in the ischemic lesion of the extremity, the kidney performance decreased. In patients with recovered blood flow in the extremities, the failure of the renal function was developing due to the inclusion syndrome. The author distinguished three stages of the syndrome severity and related functional disorders of the kidneys. Renal dysfunction should be corrected even in case of mild ischemic lesions. The authors presented the principles of their correction as well. Acute renal failure can be regarded as a death cause only in 7.7% of expired persons who had acute thromboses of arterial embolism. The author came to the conclusion that in patients with the recovered blood flow pathological changes in the morphology and functioning of the kidneys were mainly associated with the disorders in renal hemodynamics, the mechanical blockage of tubules by myoglobin degradation products, decompensated metabolic acidosis, disseminated intravascular coagulation syndrome and immediate exposure of the renal parenchyma to toxins of protein nature.
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