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ACUTE RENAL FAILURE IN CHOLANGIOCARCINOMA - A CASE REPORT

MICHAEL RAJAM GEETHA S

Abstract


Acute renal failure occurs in 8-10 percentage of  patients requiring surgery for relief of obstructive jaundice           leading to eventual mortality of 70-80 percentage. Studies have indicated that the retention of bile during cholestatic jaundice affect the integrity of cardiovascular function by reducing            peripheral vascular resistance which results in systemic          hypotension, by depressing myocardial performance, by causing profound natriuresis and diuresis that may lead to volume           depletion and ultimately result in pre-renal failure. Studies have also demonstrated that kidney functions are affected by causing tubular cell toxicity leading to acute tubular necrosis. The above

mentioned complications can be prevented by simple judicious management of the patients preoperatively by adequate             hydration and oral bile salts. Herewith is presented a case of cholangiocarcinoma, where the patient developed acute renal failure postoperatively, and was taken up for haemodialysis with very little improvement.

 


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References


Jacob Green, Ori S. Better. Systemic Hypotension and Renal Failure in Obstructive Jaundice – Mechanistic and Therapeutic Aspects. Journal of the American Society of Nephrology 1995; 5:1853-1871.

L Wang, W.F. Yu. Obstructive jaundice and perioperative management. ActaAnaesthesiologicaTaiwanica. Mar.2014.Volume 52, Issue 1, pages 22-29.

Bairaktari E, Liamis G, Tsolas O, Elisa F.M. Partially reversible renal tubular damage in patients with obstructive jaundice. Hepatology. 2001; 33(6):1365-1369.

Rafat C, Burbach M et al. Bilirubin associated acute tubular necrosis in a kidney transplant patient. Am J Kidney Dis. 2013 May;61(5):782-5.

Padilo J, Puente J, Gomez M et al. Improved cardiac function in patients with obstructive jaundice after Internal Biliary Drainage.Annals of Surgery, 2001; Vol.234, No.5, 652-656.

Michiel G.H. betjes, IngeborgBajema. The pathology of jaundice related renal insufficiency: cholemicnephrosis revisited. J. Nephrol.2006; 19: 229-233

Wen Li, Angus CW Chan et al. Superoxide and nitric oxide production by kupffer cells in rats with obstructive jaundice: Effect of internal and external drainage. Journal of Gastroenterology and

Hepatology. 2004; Volume 19: Issue 2: Pages 160-165.

Sitprija V, Kashemsant U, Sriratanaban A, Arthachintha S, Poshyachinda V. Renal function in obstructive jaundice in man: cholangiocarcinomamodel. Kidney Int. 1990: 38: 948- 955.

J. A. Pain, C. J. Cahill et al. Prevention of postoperative renal dysfunction in patients with obstructive jaundice: A multicentre study of bile salts and lactulose. British Journal of Surgery. 1991; Volume 78: Issue 4: pages 467-469.


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