Dysfunction of a singl kidney in patients after nephrectomy
Objective. Determination of the incidence and risk factors for renal failure in patients with a single kidney remaining after nephrectomy (NE).Orlova G.M., Lapshaeva T.V.
Material and methods. Determination of the incidence of single kidney dysfunction in 172 patients who underwent NE. A comparative analysis of single kidney function was performed depending on the cause of NE, time since NE, and clinical and laboratory characteristics of patients before NE.
Results. Hypercreatininemia was detected in 24.4% of patients. Arterial hypertension (AH) before NE is an independent risk factor for renal dysfunction. In patients undergoing kidney cancer surgery, additional risk factors for renal dysfunction include age over 60 years and male gender. In patients undergoing surgery for urological diseases, an additional risk factor is frequent recurrences of pyelonephritis in a single kidney. Two main mechanisms for the development of renal failure have been hypothesized: glomerular and tubulointerstitial. Increased blood β2-microglobulin levels and urine α1-microglobulin levels have been found in patients with dysfunction of a single kidney.
Conclusion. The identification of AH as a universal risk factor for renal failure in patients with a single kidney necessitates mandatory blood pressure monitoring. To prevent the development and progression of renal failure in patients with a single kidney, it is necessary to consider the underlying mechanism of nephrosclerosis and implement appropriate treatment. Blood β2-microglobulin and urine α1-microglobulin are earlier markers of renal failure than blood creatinine in patients with a single kidney.
Keywords
solisingletary kidney
nephrectomy
renal failure
risk factors
blood β2-microglobulin
urine α1-microglobulin
About the Authors
Galina M. Orlova – Dr.Sci. (Med.), Professor, Irkutsk State Medical University. Address: 1 Krasnogo Vosstaniya St., Irkutsk, 664003; e-mail: vicgal@yandex.ru.ORCID: 0000-0003-1805-8641
Tatyana V. Lapshaeva – Cand.Sci. (Med.), Nephrologist, Irkutsk Regional Consultative and Diagnostic Center. Address: 109 Baikalskaya St., Irkutsk, 664047;
e-mail: lapshaeva@dc.baikal.ru. ORCID: 0009-0006-9026-9290
Similar Articles
