The effect of iloprost on renal function in patients with critical limb ischemia.
The effect of iloprost on renal function in patients with critical limb ischemia.
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DOI：
10.1016/j.curtheres.2013.06.002
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发表时间：
2013-12
影响因子：
1.9
通讯作者：
Findik, Orhan
中科院分区：
文献类型：
--
作者：
Ay, Yasin;Kara, Ibrahim;Ay, Nuray Kahraman;Aydin, Cemalettin;Koksal, Cengiz;Gorur, Durmus Alper;Findik, Orhan
伊洛前列素对微血管空间有效，对具有广泛微血管网络的肾脏有有益作用。我们的目的是评估伊洛前列素治疗对严重肢体缺血患者肾功能的影响。对2010年9月至2012年12月在我诊所接受伊洛前列素治疗的48例危重肢体缺血患者进行前瞻性评价。将患者分为慢性肾功能不全组（I组）和肾功能正常组（II组）。尿白蛋白：肌酐比值和肾小球滤过率（GFR）采用血清肌酐和血清胱抑素C （GFRcyc）计算确定肾功能不全的存在。镇痛需求的减少、步行距离、溃疡直径的减小、踝肱指数的增加以及血管外科学会/国际心血管外科学会标准的变化被用于评估治疗效果。58.3% （n = 28）的受试者治疗后阿片类镇痛需求和卧位疼痛消失。步行距离增加66.6% （n = 32）。依洛前列素治疗显著提高踝肱指数（P < 0.01）。I组血清尿素、肌酐和胱抑素C水平显著降低（P < 0.05），而GFRcyc和GFR（按特定种族、性别和血清肌酐表达，单位为毫克/分升）与预处理水平相比显著升高（P < 0.05）。尿白蛋白与肌酐比值无显著变化（P < 0.05）。伊洛前列素在危急肢体缺血时的应用可以减缓早期肾损害的进展。GFRcyc和胱抑素C是早期慢性肾功能不全的指标，可用于评价治疗效果。
Iloprost, which has efficacy in the microvascular space, is shown to have beneficial effects on the kidney, which has an extensive microvascular network. We aimed to evaluate the effect of iloprost treatment on kidney functions in patients with critical limb ischemia. Forty-eight patients with critical limb ischemia who were not suitable for revascularization and who were treated with iloprost were evaluated prospectively in our clinic between September 2010 and December 2012. The patients were divided into 2 groups as patients with chronic renal dysfunction (Group I) and patients with normal renal function (Group II). Urine albumin:creatinine ratio and glomerular filtration rate (GFR) calculated using serum creatinine and serum cystatin C (GFRcyc) were used to establish the presence of renal dysfunction. The decrease analgesic requirement, walking distance, reduction in ulcer diameter, the increase in ankle-brachial index, and changes in The Society of Vascular Surgery/International Society of Cardiovascular Surgery criteria were used in the evaluation of treatment response. Opioid analgesic requirement and decubitus pain disappeared after treatment in 58.3% (n = 28) of subjects. Walking distance increased in 66.6% (n = 32). Iloprost treatment significantly increased ankle-brachial index (P < 0.01). In Group I the levels of serum urea, creatinine, and cystatin C significantly decreased (P < 0.05), whereas GFRcyc and GFR calculated using the equation of the Chronic Kidney Disease Epidemiology Collaboration (ie, GFR expressed for specified race, sex, and serum creatinine in milligrams per deciliter) was increased significantly compared with pretreatment levels (P < 0.05). No significant change was observed in urine albumin:creatinine ratio (P > 0.05). The use of iloprost in critical limb ischemia can slow down the progress of early stage renal damage. GFRcyc and cystatin C, which are indicators of early stage chronic renal dysfunction, can be used for the evaluation of treatment response.