Results of endovascular reconstruction in patients with dialysis-dependent ischemic kidney disease due to bilateral renal artery occlusive disease.
A. Ya. Bedrov,
V. A. Dobronravov,
A. A. Moiseev,
A. A. Vrabiy,
G. I. Popov,
D. V. Ovcharenko,
A. V. Biryukov,
E. A. Vorobyev,
O. B. Bystrova,
K. A. Belova,
M. A. Molozina,
G. G. Khubulava https://doi.org/10.24884/0042-4625-2026-185-1-91-99
Abstract
The OBJECTIVE was to evaluate the results of endovascular reconstruction in patients with dialysis-dependent ischemic kidney disease caused by bilateral renal artery disease.
METHODS AND MATERIALS. From October 2017 to September 2024, in the Department of Vascular Surgery of the Pavlov First Saint Petersburg State Medical University, 174 patients (100 men and 74 women, mean age 65±7 years) underwent endovascular reconstruction of renal arteries, including 3 (2 %) patients with dialysis-dependent ischemic kidney disease. Preoperative examination of patients included an assessment of clinical manifestations, laboratory parameters (serum creatinine and urea levels, estimated glomerular filtration rate), ultrasound examination of the kidneys with an assessment of the thickness and condition of the parenchyma, parameters of extrarenal and intrarenal arterial blood flow (peak systolic blood flow velocity, resistivity indices), and performing catheter arteriography and/or CT angiography. In patients with dialysis-dependent ischemic kidney disease, indications for revascularisation were the hemodynamically significant damage to both renal arteries and signs of preserved renal parenchyma viability. In the immediate and late postoperative period, renal function was assessed based on clinical, laboratory, and instrumental data.
RESULTS. Bilateral hemodynamically significant (stenosis > 50 % or occlusion) renal artery lesions were detected in 69 (40 %) patients. Clinical observations of 3 (2 %) patients are presented, in whom restoration of patency of one or both renal arteries through endovascular reconstruction allowed discontinuing haemodialysis.
CONCLUSION. In the presented case series with occlusive-stenotic lesions of the renal arteries, 2 % of patients had a dialysis-dependent form of ischemic kidney disease. Timely endovascular reconstruction of the renal arteries in such patients can lead to regression of renal dysfunction and discontinuation of renal replacement therapy.
About the Authors
A. Ya. Bedrov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Bedrov Alexander Ya., Dr. of Sci. (Med.), Professor of the Department of Hospital Surgery with the Clinic, Head of the Department of Vascular Surgery
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
V. A. Dobronravov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Dobronravov Vladimir A., Dr. of Sci. (Med.), Professor of the Department of Propaedeutics of Internal Diseases with the Clinic, Professor of the Department of Nephrology and Dialysis of the Faculty of Postgraduate Education, Director of the Scientific Research Institute of Nephrology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
A. A. Moiseev
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Moiseev Aleksey A., Cand. of Sci. (Med.), Assistant of the Department of Hospital Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
A. A. Vrabiy
Pavlov University
Competing Interests:
Vrabiy Andrey A., Cand. of Sci. (Med.), Cardiovascular Surgeon of the Department of Vascular Surgery, Research Institute of Surgery and Emergency Medicine
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
G. I. Popov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Popov Guriy I., Cand. of Sci. (Med.), Assistant of the Department of Faculty Surgery with courses in Laparoscopic and Cardiovascular Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
D. V. Ovcharenko
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Ovcharenko Dmitry V., Cand. of Sci. (Med.), Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment № 2
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
A. V. Biryukov
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Biryukov Alexey V., Cand. of Sci. (Med.), Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment № 1
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
E. A. Vorobyev
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Vorobyev Eugene A., Assistant of the Department of Propaedeutics of Internal Diseases with the Clinic, Nephrologist of the Nephrological Department № 1
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
O. B. Bystrova
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Bystrova Olga B., Nephrologist of the Nephrological Department № 2, Scientific Research Institute of Nephrology
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
K. A. Belova
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Belova Ksenia A., Assistant of the Department of Faculty Surgery with courses in Laparoscopic and Cardiovascular Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
M. A. Molozina
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Molozina Milana A., third-year Clinical Resident of the Department of Faculty Surgery with courses in Laparoscopic Surgery and Cardiovascular Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
G. G. Khubulava
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Khubulava Gennady G., Dr. of Sci. (Med.), Professor, Academician of the RAS, Head of the Department of Faculty Surgery with courses in Laparoscopic and Cardiovascular Surgery with the Clinic
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
The authors declare no conflict of interest.
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For citations:
Bedrov A.Ya., Dobronravov V.A., Moiseev A.A., Vrabiy A.A., Popov G.I., Ovcharenko D.V., Biryukov A.V., Vorobyev E.A., Bystrova O.B., Belova K.A., Molozina M.A., Khubulava G.G. Results of endovascular reconstruction in patients with dialysis-dependent ischemic kidney disease due to bilateral renal artery occlusive disease. Grekov's Bulletin of Surgery. 2026;185(1):91-99. (In Russ.) https://doi.org/10.24884/0042-4625-2026-185-1-91-99
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