title: Surgical rescue and restoration of renal function in an anuric renal failure patient: a case report.
abstract: We present a case of anuric renal failure in a forty-nine year old woman secondary to bilateral renal artery occlusion that responded favorably to surgical revascularization. The patient presented with a three day history of diminished to absent urine output. The patient's BUN and creatinine were 52 mg/dL and 9.3 mg/dL, respectively. The patient remained anuric and required hemodialysis. Chronic atherosclerotic occlusion of both renal arteries with reconstitution of the renal arteries via collateral support was seen on angiography. Twenty-six days after presentation, the patient had aortorenal artery bypass using a saphenous vein graft. Postoperatively the patient had excellent diuresis with the creatinine improving to a nadir of 1.5 mg/dL. This case is a demonstration that the kidneys can remain viable with subacute renal artery occlusion in the presence of adequate collateral blood flow. Surgical or transcatheter renal revascularization should be considered in appropriate patients.
authors.affiliation: West Virginia University School of Medicine, Charleston Division, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Campbell
authors.forename: Molly
authors.initials: M
authors.lastname: John
authors.forename: Mark C
authors.initials: MC
authors.lastname: Bates
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000601:surgery*; D001002:Anuria / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery*; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D008875:Middle Aged; D012077:Renal Artery / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000601:surgery*