Влияние инфузионной терапии на функцию почек и лабораторные показатели в однодневном эксперименте

Abstract

Changing views on the composition of infusion therapy in medical practice over the last decade is associated with certain side effects of infusion solutions. It is of relevance to study their influence on the kidneys, metabolism, electrolyte composition and, ultimately, on the patient's treatment results. The aim of the present work is to determine the effect of colloid and crystalloid solutions on renal function and laboratory parameters in experiment. The experimental study was performed on 28 rats (males) of Wistar line. Four experimental groups were formed: I control (n=7) — intact animals (without infusions and laparotomy), II (n=7) — laparotomy without infusions, III (n=7) — laparotomy + infusion of 6 ml of 6% hydroxyethyl starch, IV (n=7) — laparotomy + infusion of 6 ml of 0.9% sodium chloride solution. All animals underwent hematologic and biochemical blood tests, morphologic studies of kidneys. The most pronounced changes in blood tests and morphology were revealed during infusion of 6 ml of 0.9% sodium chloride solution. We observed leukopenia, decreased levels of albumin, cystatin C, cholesterol, alpha-amylase activity, increased concentration of bile acids compared to groups I and II. Morphologic study revealed significant dilatation of capsules of a part of tubules with dilated lumen of their capillaries, irregularly expressed full blood vessels. In addition, displacement of nuclei of nephrothelium to the apical pole of the cell was noted in the absence of homogeneity of cytoplasm with the presence of "enlightenments" in it. Infusion of hydroxyethyl starch did not change the main hematologic and biochemical blood parameters, except for the increase in alpha-amylase activity. Morphologic study did not reveal changes that would lead to acute kidney damage. All changes were reversible. Infusion of physiological solution caused shifts in both hematologic and biochemical blood parameters, in particular, hypoalbuminemia. The results of histologic study indicated redistribution of fluid in the interstitium.