[A look at the problem of surgical treatment of renal cel carcinoma in the aspect of biomolecular diagnosis and assessment of renal function].

The article reviews the domestic and international literature on the issues of biomolecular diagnosis of acute renal injury in the perioperative period in patients with renal cell carcinoma (RCC). Emerging opportunities for early detection of tumors make even more relevant the use of minimally invasive interventions. Of equal importance is the assessment of renal function in patients with diagnosed RCC and the prediction of acute renal injury and progression of chronic kidney disease in the postoperative period. The authors performed a systematic search for preclinical and clinical studies to identify the main trends and achievements in the field of biomolecular diagnosis of RCC and renal injury allowing the individual approach to choosing surgical treatment, improve the survival and quality of life of the patient and improve the functional state of the renal parenchyma.

[Monocytic chemotaxic protein-1 and beta2-microglobulin: a role in estimation of renal parenchyma damage in surgical treatment of nephrolithiasis].

To estimate renal damage and intensity of tubulointerstitial fibrosis basing on the data of modern molecular markers in surgical treatment of nephrolithiasis, we examined the results of surgical treatment of 200 nephrolithiasis patients divided into 5 groups by the method of surgery. We estimated content of molecular mediators of nephrofibrosis in the urine and severity of renal dysfunction. We were the first to follow up urinary excretion of proinflammatory and profibrotic monocytic chemoattractant protein-1 (MCP-1) and low-molecular protein beta-2-microglobulin which is a reliable indicator of tubular impairment. Our study demonstrated the highest efficacy and low traumatic risk of percutaneous nephrolithotripsy. We determined diagnostic levels of the studied laboratory indices which can be used for identification of impacts on nephrofibrosis processes.

[Endothelial dysfunction in urolithiasis patients].

To characterize endothelial dysfunction in operated nephrolithiasis patients, we studied NO, VEGF, ET-1, IL-6 concentration in the blood serum and NO in the urine of nephrolithiasis patients divided into three groups by the type of surgical treatment before operation, 7-10 days and 1 month after it. We used beta-2 microglobulin as an indicator of tubular dysfunction. We found a significant rise of a concentration of the endothelial dysfunction markers ET-1, IL-6 and VEGF in the blood serum (p < 0.05), showing endothelial dysfunction in nephrolithiasis patients, especially in early postoperative period after multiple exposure to short-wave lithotripsy. One month after open surgery or lithotripsy a complete recovery of endothelial function was not recorded.

[Pyeloureteral anastomosis in kidney transplantation]. / Pieloureteroanastomoz pri peresadke pochki.

Urological complications of kidney transplantation remain a serious postoperative problem. They occur in 2-10% of cases. The authors present the data on 102 cadaveric and 74 syngenesioplastic transplantations of the kidney. 70 patients underwent surgery according to the alternative technique with ipsilateral nephrectomy and establishment of pyeloureteroanastomosis. Urological complications, lethal outcomes, destruction of the transplant occurred in 9.77, 11.11, 55.6% of the patients, respectively. Application of pyeloureteroanastomosis entailed complications in 4.28%, of ureteroneocystostoma in 13%, pyelopyeloanastomosis in 2 cases of 4. In urological complications pyeloureteroanastomosis often is the only feasible reconstructive operation saving the transplant. Its advantages make it treatment of choice in primary reconstruction of the urinary tracts in kidney transplant recipients with relatively low risk of urological complications.