中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (07): 473-476.doi: 10.3969/j.issn.1671-4091.2021.07.010

• 临床研究 • 上一篇    下一篇

肾动脉狭窄合并血液透析患者经介入治疗后的肾脏预后分析

姚宇璇1,汤臣1,王梓1,刘立军1,周福德1   

  1. 1北京大学第一医院肾内科，北京大学肾脏病研究所，卫健委重点实验室，教育部慢性肾脏病防治重点实验室，中国医学科学院免疫介导肾病诊治创新单元
  • 收稿日期:2021-04-09 修回日期:2021-05-14 出版日期:2021-07-12 发布日期:2021-07-21
  • 通讯作者: 刘立军 lijun.liu@aliyun.com E-mail:lijun.liu@aliyun.com

Renal prognosis of hemodialysis patients with renal artery stenosis after interventional therapy

  1. 1Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Research Units of Diagnosis and Treatment of ImmunEmediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China
  • Received:2021-04-09 Revised:2021-05-14 Online:2021-07-12 Published:2021-07-21

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摘要： 【摘要】目的肾动脉狭窄合并血液透析患者行肾动脉介入治疗后肾脏能否获益尚不清楚。本研究旨在研究肾动脉介入治疗对肾动脉狭窄合并血液透析患者的肾脏预后的影响。方法回顾性分析1993年2 月～2021 年1 月内北京大学第一医院收治的19 例肾动脉狭窄合并血液透析患者经肾动脉介入治疗的临床资料。主要终点为术后脱离透析、死亡、肾移植；次要终点为介入前后血压控制情况、肾动脉再狭窄、再次进入透析。结果53%(10/19)的患者介入治疗后脱离透析，70%(7/10)的患者至随访终止仍脱离透析。介入治疗前的血肌酐值(t=-4.294, P＜0.001)、估算的肾小球滤过率(t=3.548, P=0.095)、肾脏长径(t=3.151, P=0.012)及介入前维持透析时间(t= 1.879, P=0.065)是介入治疗有效的影响因素。所有患者均未发生严重并发症。结论对于肾动脉狭窄合并血液透析患者，肾动脉介入治疗可能有助于患者脱离透析。尤其是对于术前血肌酐值较低、肾脏未完全萎缩及介入前维持透析时间较短的患者。

关键词: 肾动脉狭窄, 血液透析, 肾动脉介入治疗

Abstract: 【Abstract】Objective The renal benefit of renal arterial interventional therapy in hemodialysis patients with renal artery stenosis remains unclear. The purpose of this study was to investigate the effect of renal artery interventional therapy on renal prognosis in hemodialysis patients with renal artery stenosis. Methods The clinical data of 19 hemodialysis patients with renal artery stenosis admitted to the Renal Division, Peking University First Hospital from February 1993 to January 2021 were retrospectively analyzed. The primary endpoints were postoperative dialysis discontinuation, death, or kidney transplantation. The secondary endpoints
were blood pressure control before and after intervention, renal artery restenosis, or rEentry to dialysis. Results Ten of the 19 patients (53%) discontinued dialysis after interventional therapy. Serum creatinine (P＜0.001), estimated glomerular filtration rate (P=0.095), length of renal diameter (P=0.012) and maintenance time of dialysis before interventional therapy (P=0.065) were the factors for the efficacy of interventional therapy. No serious complications occurred in any of the patients. Conclusion For hemodialysis patients with renal artery stenosis, renal artery interventional therapy may help patients free from dialysis. This is especially true for patients with low serum creatinine value preoperatively, incomplete renal atrophy, and shorter maintenance time of dialysis before intervention.

Key words: Renal artery stenosis, Hemodialysis, Renal arterial interventional therapy

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