Methods and systems for reducing substance-induced renal damage
First Claim
1. A method of preventing or reducing the severity of renal damage due to a blood-borne substance that is toxic to the kidneys of a human or veterinary patient, the method comprising the steps of:
- positioning an endovascular heat exchange device in a blood vessel of the patient; and
using the endovascular heat exchange device to cool at least the patient'"'"'s kidneys to a temperature at which the substance-induced renal damage is prevented or reduced in severity.
6 Assignments
0 Petitions
Accused Products
Abstract
Methods for reducing kidney damage induced by radiographic contrast medium or another nephrotoxic drug or substance administered to or generated by a patient include reducing the temperature of the patient by positioning an endovascular heat exchange device in a blood vessel of the patient and adjusting the temperature of the device to cause a reduction in the patient'"'"'s temperature. The patient'"'"'s temperature may be reduced prior to, during, and/or after, the administration of the contrast medium. The methods may also include administering an anti-shivering mechanism to the patient to reduce shivering caused by the reduction in the patient'"'"'s temperature. The methods may also include disrupting the laminarity of blood flow around the device to enhance the temperature exchange between the device and the blood flowing around the device. The endovascular heat exchange device may be an endovascular heat exchange catheter. The device may be a component of a system, which includes a temperature controller in communication with the endovascular heat exchange device to reduce the temperature of the patient to reduce the temperature of the patient'"'"'s kidneys.
214 Citations
49 Claims
-
1. A method of preventing or reducing the severity of renal damage due to a blood-borne substance that is toxic to the kidneys of a human or veterinary patient, the method comprising the steps of:
-
positioning an endovascular heat exchange device in a blood vessel of the patient; and
using the endovascular heat exchange device to cool at least the patient'"'"'s kidneys to a temperature at which the substance-induced renal damage is prevented or reduced in severity. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
making at least a preliminary diagnosis of overdose with a nephrotoxic substance prior to using the endovascular heat exchange device to cool at least the patient'"'"'s kidneys.
-
-
21. The method of claim 20, comprising reducing the temperature of the patient'"'"'s kidneys to a temperature that reduces ischemic injury of the kidney.
-
22. The method of claim 20, comprising reducing the patient'"'"'s temperature to a temperature between 32 degrees Celsius and 37 degrees Celsius.
-
23. The method of claim 20, further comprising a step of administering an anti-shivering treatment to the patient.
-
24. The method of claim 23, wherein the anti-shivering treatment is an anti-shivering agent selected from the group consisting of:
- dopamine receptor blockers;
dopamine receptor agonists;
kappa opioid receptor agonists;
opioid agonist-antagonist analgesics;
serotonin 5HT1a receptor agonists; and
their pharmaceutically acceptable salts.
- dopamine receptor blockers;
-
25. A method according to claim 1 wherein a kidney or a portion of the body including a kidney is cooled and wherein the method further comprises:
-
positioning a first endovascular heat exchange device in a first blood vessel of the patient through which blood flows to at least one of the patient'"'"'s kidneys;
positioning a second endovascular heat exchange device in a second blood vessel of the patient through which blood flows from at least one of the patient'"'"'s kidneys;
using the first endovascular heat exchange device to cool blood flowing to at least one of the patient'"'"'s kidneys; and
,using the second endovascular heat exchange device to warm blood flowing from at least one of the patient'"'"'s kidneys.
-
-
26. A method according to claim 1 wherein a kidney or a portion of the body including a kidney is cooled and wherein the method further comprises:
-
positioning a first endovascular heat exchange device in the aorta upstream of the location at which a renal artery branches from the aorta;
positioning a second endovascular heat exchange device in the aorta downstream of said location at which a renal artery branches from the aorta;
using the first endovascular heat exchange device to cool blood flowing through the aorta, a portion of which flows into the renal artery; and
,using the second endovascular heat exchange device to warm the remaining blood flowing through the aorta after the portion has flowed into the renal artery.
-
-
27. A method according to claim 1 further comprising a step of monitoring the temperature of the patient.
-
28. A method according to claim 1 further comprising steps of:
-
monitoring the temperature of the patient; and
adjusting the temperature of the heat exchange catheter based on the temperature so monitored.
-
-
29. A method for preventing or reducing the severity of kidney damage in a human or veterinary patient due to the administration, ingestion, absorption or production of, or exposure to, a nephrotoxic substance, said method comprising the steps of:
-
providing a heat exchange catheter that has a heat exchanger which is positionable within a blood vessel of the patient and a controller that controls the temperature of the heat exchanger;
positioning the heat exchanger in a blood vessel of the patient without entirely preventing the flow of blood around the heat exchanger; and
controlling the temperature of the heat exchanger to reduce the temperature of the patient'"'"'s blood and to cool the patient'"'"'s kidneys, thereby preventing or reducing the severity of kidney damage. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41)
monitoring the temperature of the patient; and
adjusting the temperature of the heat exchange catheter based on the temperature so monitored.
-
-
42. A system for preventing or reducing the severity of renal damage due to a blood-borne substance that is toxic to the kidneys of a human or veterinary patient, said system comprising:
-
a heat exchange catheter insertable into a blood vessel of the patient; and
a temperature controller in communication with the heat exchange catheter to cause the heat exchange catheter to reduce the temperature of at least the a patient'"'"'s kidneys to a temperature at which the substance-induced renal damage is prevented or mitigated; and
an anti-shivering element comprising a quantity of an anti-shivering agent and apparatus for administering that anti-shivering agent to the patent. - View Dependent Claims (43, 44, 45, 46, 47, 48, 49)
temperature monitoring means for monitoring the patient'"'"'s temperature; - and
temperature adjusting means for adjusting the temperature of the heat exchange catheter to maintain a constant reduced temperature of the patient'"'"'s kidneys.
-
-
46. The system of claim 45, wherein the temperature adjusting means adjusts the temperature in response to the temperature monitored by the temperature monitoring means.
-
47. The system of claim 42, wherein the heat exchange catheter comprises a flow disruption device to disrupt the laminarity of blood flow around the catheter.
-
48. The system of claim 42, wherein the temperature controller controls the temperature and flow of heat exchange fluid flowing through the heat exchange catheter.
-
49. The system of claim 42 wherein the anti-shivering agent is selected from the group consisting of:
- dopamine receptor blockers;
dopamine receptor agonists;
kappa opioid receptor agonists;
opioid agonist-antagonist analgesics;
serotonin 5HT1a receptor agonists; and
their pharmaceutically acceptable salts.
- dopamine receptor blockers;
Specification