Solitary kidney with renal artery aneurysm : one case report with literature review / 中华泌尿外科杂志

ABSTRACT

Objective To summarize the treatment experience of the solitary kidney with renal artery aneurysm.Methods Clinical data of 1 solitary renal artery aneurysm patient treated in our hospital in May.2012 was retrospectively analyzed.The 48 yrs man with a history of hypertension for 10 years,but responded to medical treatment poorly.The highest blood pressure was up to 180/100 mmHg (1 mmHg =0.133 kPa).Preoperative check found that the serum creatinine was 64 μmol/L.Color Doppler ultrasound showed no detection of left kidney,the renal artery enlarged to the range of 21 mm× 14 mm.CT scan showed that the right renal artery locally enlarged,suggesting artery aneurysm.Renal computerized tomography angiography showed that left renal agenesis,right renal with artery aneurysm close to the renal hilum with size of 17.1 mm× 19.1 mm,was located on the distal renal artery bifurcation,involving 2 artery branches.The diagnosis was right solitary kidney with renal artery aneurysm.Renal aneurysm clip occlusion was performed under general anesthesia,blood pressure was controlled to 70/40 mmHg during the procedure.After exposing the renal artery,the renal artery was visible with a diameter of 25 mm and with a basement width about 19 mm,which located in the main renal artery and overrode the branches of the two renal arteries.After the clamp of the artery aneurysm from two sides to center and the middle part of it was overlapped,the artery aneurysm reduced obviously,and clipped the aneurysmal wall with noose suture.When loosen the clamp of main renal artery,the artery aneurysm was not enlarged,blood pressure up to 120/80 mmHg.Results The operation was successful,operation time was 75 min,intraoperative blocking time was 15 min,intraoperative blood loss was 50 ml,and there was no intraoperative and postoperative complication.Postoperatively immediate and the first postoperative day serum creatinine were 95 μmol/L and 150 μmol/L.2 week after surgery the index decreased to 74 μmol/L.After operation the blood pressure was control successful,and kept at 130/80 mmHg.Conclusions Solitary kidney with renal artery aneurysm is rare.Renal aneurysm clip occlusion is a safe,effective and feasible treatment option,especially for the patients with solitary kidney.