ПРОФИЛАКТИКА И ЛЕЧЕНИЕ ОСТРОГО ПОВРЕЖДЕНИЯ ПОЧЕК ПРИ КАРДИОХИРУРГИЧЕСКИХ ОПЕРАЦИЯХ С ИСКУССТВЕННЫМ КРОВООБРАЩЕНИЕМ И ТРАНСПЛАНТАЦИИ СЕРДЦА
Аннотация
Острое повреждение почек является одним из наиболее частых и серьезных осложнений у пациентов при операциях с искусственным кровообращением и трансплантации сердца, в значительной степени опреде- ляющим прогноз. Приоритетным направлением является разработка профилактических мер и оптималь- ных методов лечения, в первую очередь заместительной почечной терапии (ЗПТ). До настоящего времени не известно ни одного препарата, обладающего доказанными нефропротективными свойствами. По не- которым данным, применение профилактического диализа позволяет снизить потребность в послеопера- ционной ЗПТ. Постоянные и интермиттирующие методики ЗПТ являются взаимодополняющими. Совре- менными тенденциями являются раннее и даже профилактическое использование ЗПТ и повышение ее эффективности. Однако нет ясности, насколько должны быть расширены показания и до какой степени увеличена доза ЗПТ для достижения оптимальных результатов.
Ключевые слова
Об авторах
Ю. В. КопыловаРоссия
Я. Л. Поз
Россия
А. Г. Строков
Россия
В. Н. Попцов
Россия
О. В. Воронина
Россия
С. Г. Ухренков
Россия
Список литературы
1. Tang A.T., El-Gamel A., Keevil B. et al. The effect of ‘renal-dose’ dopamine on renal tubular function follow- ing cardiac surgery: assessed by measuring retinol bind- ing protein (RBP) // Eur. J. Cardiothorac. Surg. 1999. Vol. 15. P. 717–721.
2. Woo E.B., Tang A.T., El-Gamel A. et al. Dopamine thera- py for patients at risk of renal dysfunction following cardiac surgery: science or fiction? // Eur. J. Cardiothorac.
3. Surg. 2002. Vol. 22. P. 106–111.
4. Dunning J., Khasati N., Barnard J. Low dose (renal
5. dose) dopamine in the critically ill patient // Interact.
6. Cardiovasc. Thorac. Surg. 2004. Vol. 3. P. 114–117.
7. Friedrich J.O., Adhikari N., Herridge M.S., Beyene J. Meta-analysis: low-dose dopamine increases urine out- put but does not prevent renal dysfunction or death //
8. Ann. Intern. Med. 2005. Vol. 142. Р. 510–520.
9. Stone G.W., McCullough P.A., Tumlin J.A. et al. Fenoldo- pam mesylate for the prevention of contrast-induced ne- phropathy: a randomized controlled trial // JAMA. 2003.
10. Vol. 290. P. 2284–2291.
11. Caimmi P.P., Pagani L., Micalizzi E. et al. Fenoldopam
12. for renal protection in patients undergoing cardiopul- monary bypass // J. Cardiothorac. Vasc. Anesth. 2003. Vol. 17. P. 491–494.
13. Garwood S., Swamidoss C., Davis E.A. et al. A case se- ries of low-dose fenoldopam in seventy cardiac surgical patients at increased risk of renal dysfunction // J. Car- diothorac. Vasc. Anesth. 2003. Vol. 17. P. 17–2l.
14. Ranucci M., Soro G., Barzaghi N. et al. Fenoldopam prophylaxis of postoperative acute renal failure in high- risk cardiac surgery patients // Ann. Thorac. Surg. 2004. Vol. 78. P. 1332–1337.
15. Bove T., Landoni G., Calabro M.G. et al. Renoprotective action of fenoldopam in high-risk patients undergoing cardiac surgery: a prospective, double-blind, random- ized clinical trial // Circulation. 2005. Vol. 111. P. 3230– 3236.
16. Brienza N., Malcangi V., Dalfino L. et al. A comparison between fenoldopam and low-dose dopamine in early re- nal dysfunction of critically ill patients // Crit. Care Med. 2006. Vol. 34. P. 707–714.
17. Rosner M., Portilla D., Okusa M. Cardiac surgery as a cause of acute kidney injury: pathogenesis and potential therapies //J. Intensive Care. Med. 2008. Vol. 23. P. 3–18.
18. Kramer B.K., Preuner J., Ebenburger A. et al. Lack of renoprotective effect of theophylline during aortocoro- nary bypass surgery // Nephrol. Dial. Transplant. 2002. Vol. 17. P. 910–915.
19. Light D.B., Schwiebert E.M., Karlson K.H., Stanton B.A. Atrial natriuretic peptide inhibits a cation channel in renal inner medullary collecting duct cells // Science. 1989. Vol. 243. P. 383–385.
20. Sward K., Valsson F., Odencrants P. et al. Recombinant human atrial natriuretic peptide in ischemic acute renal failure: a randomized placebo controlled trial // Crit. Care. Med. 2004. Vol. 32. P. 1310–1315.
21. Townsend D.R., Bagshaw S.M. New insights on intrave- nous fluids, diuretics and Acute Kidney Injury // Neph- ron. Clin. Pract. 2008. Vol. 109. P. 206–216.
22. Jarnberg P.O. Renal protection strategies in the peri- operative period // Best Pract. Res. Clin. Anaesthesiol. 2004. Vol. 18. P. 645–660.
23. Lassnigg A., Schmidlin D., Mouhieddine M. et al. Mini- mal changes of serum creatinine predict prognosis in pa- tients after cardiothoracic surgery: a prospective cohort study // J. Am. Soc. Nephrol. 2004. Vol. 15. P. 1597– 1605.
24. Uchino S., Doig G.S., Bellomo R. et al. Diuretics and mortality in acute renal failure // Crit. Care Med. 2004. Vol. 32:1669–1677.
25. Lombardi R., Ferreiro A., Servetto C. Renal function af- ter cardiac surgery: adverse effect of furosemide // Ren. Fail. 2003. Vol. 25. P. 775–786.
26. Mehta R.L, Pascual M.T, Soroko S., Chertow G.M. Di- uretics, mortality and nonrecovery of renal function in acute renal failure // JAMA. 2002. Vol. 288. P. 2547– 2553.
27. Cooper J.R., Giesecke N.M. Hemodilution and priming solutions // Gravlee G.P., Davis R.F., Kurusz M., Ut- ley J.R. eds. Cardiopulmonary Bypass: Principles and Practice. 2ns ed. Philadelphia: Lippincott, Williams & Wilkins. 2000. P. 186–196.
28. Fisher A.R., Jones P., Barlow P. et al. The influence of mannitol on renal function during and after open-heart surgery // Perfusion. 1998. Vol. 13. P. 181–186.
29. Carcoana O.V., Mathew J.P., Davis E. et al. Mannitol and dopamine in patients undergoing cardiopulmonary bypass: a randomized clinical trial // Anesth. Analg. 2003. Vol. 97. P. 1222–1229.
30. Smith M.N., Best D., Sheppard S.V., Smith D.C. The ef- fect of mannitol on renal function after cardiopulmonary bypass in patients with established renal dysfunction // Anaesth. 2008. Vol. 63. P. 701–704.
31. Sirivella S., Gielchinsky I., Parsonnet V. Mannitol, fu- rosemide, and dopamine infusion in postoperative re- nal failure complicating cardiac surgery // Ann. Thorac. Surg. 2000. Vol. 69. P. 501–506.
32. Cagli K., Ulas M.M., Ozisik K. et al. The intraoperative effect of pentoxifylline on the inflammatory process and leukocytes in cardiac surgery patients undergoing cardiopulmonary bypass // Perfusion. 2005. Vol. 20. P. 45–51.
33. Zhang M., Xu Y.J., Saini H.K. et al. Pentoxifylline atten- uates cardiac dysfunction and reduces TNF-{alpha}level in the ischemic-reperfused heart // Am. J. Physiol. Heart. Circ. Physiol. 2005. Vol. 289. P. H832–H839.
34. Boldt J., Brosch C., Piper S.N. et al. Influence of prophy- lactic use of pentoxifylline on postoperative organ func- tion in elderly cardiac surgery patients // Crit. Care. Med. 2001. Vol. 29. P. 952–958.
35. Loef B.G., Henning R.H., Epema A.H. et al. Effect of dexamethasone on perioperative renal function impair- ment during cardiac surgery with cardiopulmonary by- pass // Br. J. Anaesth. 2004. Vol. 93. P. 793–798.
36. Shernan S.K., Fitch J.C., Nussmeier N.A. et al. Impact of pexelizumab, an anti-C5 complement antibody, on total mortality and adverse cardiovascular outcomes in cardiac surgical patients undergoing cardiopulmonary bypass // Ann. Thorac. Surg. 2004. Vol. 77. P. 942–949.
37. Sucu N., Cinel I., Unlu A. et al. N-acetylcysteine for preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass // Surg. Today. 2004. Vol. 34. P. 237–242.
38. Tossios P., Bloch W., Huebner A. et al. N-acetylcysteine prevents reactive oxygen species-mediated myocardial stress in patients undergoing cardiac surgery: results of a randomized, double-blind, placebo-controlled clinical trial // Thorac. Cardiovasc. Surg. 2003. Vol. 126.
39. P. 1513–1520.
40. Kshirsagar A.V., Poole C., Mottl A. et al. N-acetylcys-
41. teine for the prevention of radiocontrast induced nephro- pathy: a meta-analysis of prospective controlled trials // J. Am. Soc. Nephrol. 2004. Vol. 15. P. 761–769.
42. Burns K.E., Chu M.W., Novick R.J. et al. Periopera- tive N-acetylcysteine to prevent renal dysfunction in high-risk patients undergoing CABG surgery: a ran- domized controlled trial // JAMA. 2005. Vol. 294. P. 342–349.
43. Jo S.K., Rosner M.H., Okusa M.D. Pharmacological treatment of acute kidney injury: why drugs have not worked and what is on the horizon // Clin. J. Am. Soc. Nephrol. 2007. Vol. 2. P. 356–365.
44. Awad A.S., Ye H., Huang L. et al. Selective sphingosine 1-phosphate 1 receptor activation reduces ischemia-re- perfusion injury in mouse kidney // Am. J. Physial. Re- nal. Physiol. 2006. Vol. 290. P. F1516–F1524.
45. Li L., Okusa M.D. Blocking the immune response in ischemic acute kidney injury: the role of adenosine 2A agonists // Nat. Clin. Pract. Nephrol. 2006. Vol. 2. P. 432–444.
46. Myles P.S., Hunt J.O., Holdgaard H.O. et al. Clonidine and cardiac surgery: haemodynamic and metabolic ef- fects, myocardial ischaemia and recovery // Anaesth. In- tensive Care. 1999. Vol. 27. P. 137–147.
47. Kulka P.J., Tryba M., Zenz M. Preoperative alpha2-ad- renergic receptor agonists prevent the deterioration of renal function after cardiac surgery: results of a rando- mized, controlled trial // Crit. Care Med. 1996. Vol. 24. P. 947–952.
48. Chanda J., Canver C.C. Reversal of preexisting vasos- pasm in coronary artery conduits // Ann. Thorac. Surg. 2001. Vol. 72. P. 476–480.
49. Fansa I., Gol M., Nisanoglu V. et al. Does diltiazem in- hibit the inflammatory response in cardiopulmonary by- pass? // Med. Sci. Monit. 2003. Vol. 9. P. P130–P136.
50. Amar D., Fleisher M. Diltiazem treatment does not al- ter renal function after thoracic surgery // Chest. 2001. Vol. 119. P. 1476–1479.
51. Piper S.N., Kumle B., Maleck W.H. et al. Diltiazem may preserve renal tubular integrity after cardiac surgery // Can. J. Anaesth. 2003. Vol. 50. P. 285–292.
52. Young E.W., Diab A., Kirsh M.M. Intravenous diltiazem and acute renal failure after cardiac operations // Ann. Thorac. Surg. 1998. Vol. 65. P. 1316–1319.
53. Durmaz I., Yagdi T., Calkavur T. et al. Prophylactic di- alysis in patients with renal dysfunction undergoing on- pump coronary artery bypass surgery // Ann. Thorac. Surg. 2003. Vol. 75. P. 859–864.
54. Mehta R., McDonald B., Gabbai F. et al. Collaborative Group for Treatment of ARF in the ICU. A randomized clinical trial of continuous versus intermittent dialy- sis for acute renal failure // Kidney. Int. 2001. Vol. 60. P. 1154–1163.
55. Teehan G., Liangos O., Lau J. et al. Dialysis membrane and modality in acute renal failure: understanding dis- cordant meta-analyses// Semin. Dial. 2003. Vol.16. P. 356–360.
56. Tonelli M., Manns B., Feller-Kopman D. Acute renal failure in the intensive care unit: a systematic review of the impact of dialytic modality on mortality and renal recovery // Am. J. Kidney. Dis. 2002. Vol. 40. P. 875– 885.
57. Uehlinger D.E., Jakob S.M., Ferrari P. et al. Comparison of continuous and intermittent renal replacement therapy for acute renal failure // Nephrol. Dial. Transplant. 2005. Vol. 20(8). P. 1630–1637.
58. Van Biesen W., Vanholder R., Lameire N. Dialysis stra- tegies in critically ill acute renal failure patients // Curr. Opin. Crit. Care. 2003. Vol. 9. P. 491–495.
59. Ricci Z., Ronco C., D’amico G. et al. Practice patterns in the management of acute renal failure in the critically ill patient: an international survey // Nephrol. Dial. Trans- plant. 2006. Vol. 21. P. 690–696.
60. Chang J., Yang W., Seo J. et al. Continuous veno-venous hemodiafiltration versus hemodialysis as renal replace- ment therapy in patients with acute renal failure in the intensive care unit // Scand. J. Urol. Nephrol. 2004. Vol. 38. P. 417–421.
61. De Vriese A., Vanholder R., Pascual M. et al. Can inflam- matory cytokines be removed efficiently by continuous renal replacement therapies? // Intens. Care. Med. 1999. Vol. 25. P. 903–910.
62. Fliser D., Kielstein J.T. A single-pass batch dialysis sy- stem: an ideal dialysis method for the patient in intensive care with acute renal failure // Curr. Opin. Crit. Care. 2004. Vol. 10. P. 483–488.
63. Cole L., Bellomo R., Journois D. et al. High-volume hae- mofiltration in human septic shock // Intens. Care. Med. 2001. Vol. 27. P. 978–986.
64. Kellum J., Mehta R., Angus D. et al. The first international consensus conference on соntinuous renal replacement therapy // Kidney. Int. 2002. Vol. 62. P. 1855–1863.
65. Ronco C., Bellomo R., Homel P. et al. Effects of different doses in continuous veno-venous haemofiltration on out- comes of acute renal failure: a prospective randomised trial // Lancet. 2000. Vol. 356. P. 26–30.
66. Schiffl H., Lang S.M., Fischer R. Daily hemodialysis and the outcome of acute renal failure // N. Engl. J. Med. 2002. Vol. 346. P. 305–310.
67. Saudan P., Niederberger M., De Seigneux S. et al. Ad- ding a dialysis dose to continuous hemofiltration increa- ses survival in patients with acute renal failure // Kidney. Int. 2006. Vol. 70. P. 1312–1317.
68. Faulhaber-Walter R., Hafer C., Jahr N. et al. The Han- nover Dialysis Outcome study: comparison of standard versus intensified extended dialysis for treatment of patients with acute kidney injury in the intensive care unit // Nephrol. Dial. Transplant. 2009. Vol. 24(8). P. 2602.
69. Kumar V., Craig M., Depner Т., Yeun J. Extended daily dialysis: a new approach to renal replacement for acute renal failure in the intensive care unit // Am. J. Kidney. Dis. 2000. Vol. 36. P. 294–300.
70. Kumar V., Yeun J., Depner Т. et al. Extended daily di- alysis vs. continuous hemodialysis for ICU patients with acute renal failure: a two-year single center report // Int. J. Artif. Organs. 2004. Vol. 27. P. 371–379.
71. Marshall M., Golper Т., Shaver M. et al. Urea kinetics during sustained low-efficiency dialysis in critically ill patients requiring renal replacement therapy // Am. J. Kidney. Dis. 2002. Vol. 39. P. 556–570.
72. Marshall M., Ma T., Galler D. et al. Sustained low-ef- ficiency daily diafiltration (SLEDD-f) for critically ill patients requiring renal replacement therapy: towards an adequate therapy // Nephrol. Dial. Transplant. 2004. Vol. 19. P. 877–884.
73. Stevens L-M., El-Hamamsy I., Leblanc M. et al. Con- tinuous renal replacement therapy after heart transplan- tation // Can. J. Cardiol. 2004. Vol. 20 (6). P. 619–623.
74. Augustine J.J., Sandy D., Seifert T.H. et al. A randomised, controlled trial, comparing intermittent with continuous
75. veno-venous dialysis in patients with AKI // Am. J. Kid-
76. ney. Dis. 2004. Vol. 44. P. 1000–1007.
77. Lins R., Elseviers M., van der Niepen P. et al. Inter-
78. mittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the inten- sive care unit: results of a randomized clinical trial // Nephrol. Dial. Transplant. 2009. Vol. 24. P. 512– 518.
79. Vinsonneau C., Camus C., Comber A. et al. Continu- ous veno-venous haemofiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial // Lancet. 2006. Vol. 368. P. 379– 385.
Рецензия
Для цитирования:
Копылова Ю.В., Поз Я.Л., Строков А.Г., Попцов В.Н., Воронина О.В., Ухренков С.Г. ПРОФИЛАКТИКА И ЛЕЧЕНИЕ ОСТРОГО ПОВРЕЖДЕНИЯ ПОЧЕК ПРИ КАРДИОХИРУРГИЧЕСКИХ ОПЕРАЦИЯХ С ИСКУССТВЕННЫМ КРОВООБРАЩЕНИЕМ И ТРАНСПЛАНТАЦИИ СЕРДЦА. Вестник трансплантологии и искусственных органов. 2010;12(2):92-99. https://doi.org/10.15825/1995-1191-2010-2-92-99
For citation:
Kopylova Y.V., Poz Y.L., Strokov A.G., Poptsov V.N., Voronina O.V., Uhrenkov S.G. PREVENTION AND TREATMENT OF ACUTE KIDNEY INJURY AFTER CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS AND HEART TRANSPLANTATION. Russian Journal of Transplantology and Artificial Organs. 2010;12(2):92-99. (In Russ.) https://doi.org/10.15825/1995-1191-2010-2-92-99