| Project/Area Number |
15K10536
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Anesthesiology
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| Research Institution | Osaka University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
井口 直也 大阪大学, 医学系研究科, 助教 (00372623)
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2017: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2016: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
Fiscal Year 2015: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 造影剤腎症 / 腹部大動脈瘤 / 血管内ステントグラフト内挿術 / ステント内挿術 / 循環器 / 高血圧 / 生体分子 / 生理学 / 内科 |
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| Outline of Final Research Achievements |
Contrast-induced nephropathy CIN is a complication of angiographic procedures. Our goal was to assess feasibility of inter-operative hemodialysis for the prevention of CIN in patients undergoing endovascular graft surgery. Neutrophil gelatinase-associated lipocalin (NGAL) was measured to assess the severity of renal injury in patients undergoing endovascular graft surgery and confirmed the relationship of contrast volume administration and severity of renal injury. The improvement in the spatiotemporal visualization in angiopathy, dilution method of the contrast medium and the inter operative use of pre-operative 3dementional CT scans for image enhancement contribute to a substantial reduction in contrast medium use and prevention of CIN. In conclusion, the use of inter-operative hemodialysis for the prevention of CIN does not seem feasible due to the invasive nature of inter-operative hemodialysis.
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| Academic Significance and Societal Importance of the Research Achievements |
患者へのヨード造影剤の投与は造影剤腎症の発症リスクを伴う。腹部大動脈瘤患者のステント内挿術において精密に腎障害を判断する生体マーカーを測定することで造影剤腎症発症と造影剤量の容量依存性を確認した。アンギオグラフィ撮影装置の改良、造影剤の希釈や術中画像解析強化等により造影剤投与量を大幅に減少させることで腎障害を発症するほどの投与に達しないことが明らかとなり造影剤腎症発症の予防が可能となった。血液透析による造影剤除去は現実的な造影剤腎症の発症予防法ではないことが示唆され今後治療を受ける患者にとっては意義のある成果となった。
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