【摘要】目的肾动脉狭窄合并血液透析患者行肾动脉介入治疗后肾脏能否获益尚不清楚。本研究旨在研究肾动脉介入治疗对肾动脉狭窄合并血液透析患者的肾脏预后的影响。方法回顾性分析1993年2 月～2021 年1 月内北京大学第一医院收治的19 例肾动脉狭窄合并血液透析患者经肾动脉介入治疗的临床资料。主要终点为术后脱离透析、死亡、肾移植；次要终点为介入前后血压控制情况、肾动脉再狭窄、再次进入透析。结果53%(10/19)的患者介入治疗后脱离透析，70%(7/10)的患者至随访终止仍脱离透析。介入治疗前的血肌酐值(t=-4.294, P＜0.001)、估算的肾小球滤过率(t=3.548, P=0.095)、肾脏长径(t=3.151, P=0.012)及介入前维持透析时间(t= 1.879, P=0.065)是介入治疗有效的影响因素。所有患者均未发生严重并发症。结论对于肾动脉狭窄合并血液透析患者，肾动脉介入治疗可能有助于患者脱离透析。尤其是对于术前血肌酐值较低、肾脏未完全萎缩及介入前维持透析时间较短的患者。
【Abstract】Objective The renal benefit of renal arterial interventional therapy in hemodialysis patients with renal artery stenosis remains unclear. The purpose of this study was to investigate the effect of renal artery interventional therapy on renal prognosis in hemodialysis patients with renal artery stenosis. Methods The clinical data of 19 hemodialysis patients with renal artery stenosis admitted to the Renal Division, Peking University First Hospital from February 1993 to January 2021 were retrospectively analyzed. The primary endpoints were postoperative dialysis discontinuation, death, or kidney transplantation. The secondary endpoints
were blood pressure control before and after intervention, renal artery restenosis, or rEentry to dialysis. Results Ten of the 19 patients (53%) discontinued dialysis after interventional therapy. Serum creatinine (P＜0.001), estimated glomerular filtration rate (P=0.095), length of renal diameter (P=0.012) and maintenance time of dialysis before interventional therapy (P=0.065) were the factors for the efficacy of interventional therapy. No serious complications occurred in any of the patients. Conclusion For hemodialysis patients with renal artery stenosis, renal artery interventional therapy may help patients free from dialysis. This is especially true for patients with low serum creatinine value preoperatively, incomplete renal atrophy, and shorter maintenance time of dialysis before intervention.
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