Effect of nephroprotection therapy on kidney function at resection

Abstract

The aim – to compare two prevention methods of nephrosclerosis after resection of the kidney. Material and methods. In group 1 were included 83 patients in whom the kidney were resected during surgery was used general anesthesia and mechanical ventilation, in group 2–23 patients in whom anesthesia was used for general anesthesia with mechanical ventilation in combination with prolonged epidural analgesia. Patients in both groups received perioperative period nephroprotective therapy which included the administering two days before surgery enalapril 5 mg once a day, which continued to take in postoperative period, followed in such doses within one year after the surgery, intraoperative pentoxifylline administration of 5 ml, followed by administration of 5 ml twice per day for three days. Monitoring of blood pressure, glomerular filtration rate and β2-microglobulin in plasma. Results. It was found that using both methods nephroprotection no effect on hemodynamic parameters. The volume of blood loss was significantly lower when using an epidural. Glomerular filtration rate in group 1 was lower at the end of the 7th day when compared with group 2, although not statistically significant. The content of β2-microglobulin in plasma significantly increased compared with preoperative values and continued to be kept in such figers at 3, 6 and 12 months follow-up. Although fluctuations of content β2-microglobulin in plasma were statistically significant they do not exceed the reference values. Comparing group 1 and group 2 on stage study st atistically significant changes were set at 6 and 12 months postoperative. The content of β2-microgl obulin in plasma was higher in group 1.Conclusions. The use nephroprotective therapy does not cause significant hemodynamic fluctuations, safe kidney function. Determination of β2-microglobulin in plasma is a valuable method for early diagnosis of renal impairment.