Renal revascularization in anuric patients: determinants of outcome

We describe three patients who recently had surgical revascularization for prolonged anuria due to renal artery occlusion. A review of the literature revealed 31 similar patients with sufficient data to allow comparison. There was no correlation between the interval of anuria and the surgical outcome regarding survival, renal function, and blood pressure. On renal angiography, 16 patients had nephrogram as evidence of collateral circulation. Seven patients had no renal perfusion. There was no significant difference in renal function, blood pressure, or survival after renal reperfusion in patients with or without nephrogram. In patients who received vascular grafts, the postoperative serum creatinine level and blood pressure were significantly lower than those of patients who had thromboendarterectomy (P less than .05). In contradistinction to commonly held concepts, these findings are independent of collateral circulation.