[Mechanical kidney injury what urologists miss in medical records].

The article provides a brief description of the main terms and concepts of kidney damage used in forensic medicine and urology, with a list of requirements for the description and formation of a clinical diagnosis when maintaining primary medical documentation. The importance of a unified approach in objective interpretation in the expert assessment of kidney injuries is substantiated.

[Correlation adaptometry as a method of renal assessment and rganismic interaction with closed kidney injury].

INTRODUCTION: The kidney concussion causes damage to intraorganic angioarchitectonics, microcirculatory disorders, as a consequence - a decrease in functional capabilities of the organ, affecting inter-system interrelationships in the organism. PURPOSE OF THE STUDY: to evaluate the interaction of renal functions and hemodynamic homeostasis by the method of correlation adaptometry in groups of victims after closed kidney injury with different areas of organ damage. MATERIALS AND METHODS: The study involved 114 patients with isolated comotional kidney injury Grade I-III, with the involvement of the 1st organ segment - 30 (26.0%), 2 segments - 26 (22.8%), 3 segments - 58 (51.2%). A radionuclide study was performed, the parameters of hemodynamic homeostasis were determined, and the functional stress index (IFN) was calculated. The assessment of the contingency of the analyzed parameters was carried out on the basis of correlation analysis, and the degree of connectivity of the parameters was estimated using the correlation graph. RESULTS: It was found that with an increase in the number of damaged segments of the kidney, the main physiological parameters of the organ regress together with an increase in functional deficit. Vector decrease of functional capabilities of the organism by IFN was noted: from satisfactory adaptation (when kidney segment 1 was injured); through tension of adaptation mechanisms (2 segments); to unsatisfactory adaptation (3 segments), when homeostasis was preserved with significant tension of regulatory systems. The correlation graph was recorded at the level of 11,96 and 11,57 in trauma of the 1st and 2nd segments of the kidney. In case of damage to 3 segments of the organ, the weight of the correlation graph increases - 16,97, which indicates pronounced structural and functional maladaptive disorders in the activity of the organ. CONCLUSION: assessment of the conjugacy of indicators of renal and organism interaction, indicates the greatest tension of the reserves of functional potential of the organism in case of damage of 3 segments of the kidney.

[Cluster analysis of the main parameters of homeostasis with kidney injury].

INTRODUCTION: Damage to the structure of the kidney in blunt trauma leads to disruption of angioarchitectonics and microcirculation. OBJECTIVE: to establish the dependence of renal function and circulatory system on the severity of injury and the type of blunt renal trauma. MATERIALS AND METHODS: The clinical and laboratory homeostasis tests were carried out in 127 patients with the kidney parenchyma contusion and ruptures in the nearest posttraumatic period. RESULTS: Five factors and five clusters of signs were revealed. Tissue level reactions predominate in case of contusion injury of less than half of the organ. Trauma of more than half of the kidney and parenchyma rupture involve the circulatory system in the response reaction. CONCLUSION: the volume/area and type of damage are predictors in the level of the functional response of the organism - organ or organismal.

[The closed injury of a kidney and posttraumatic arterial hypertension: condition of study of a problem].

The article summarizes the worlds information on the history of the study, classification, management tactics of patients with closed kidney injury, analysis of the development of post-traumatic arterial hypertension (AH). In a research of renovascular and renoparenchymal mechanisms of a syndrome of AG there is no consensus of dependence on severity of injury of a kidney, a type of treatment, about the temporary period between getting injured and emergence of a complication that defines relevance of further studying.

[The application of superselective embolization of renal vessels in case of bleeding after percutaneous nephro- lithotomy].

BACKGROUND: Bleeding, injures to surrounding organs and pleura are serious complications of percutaneous nephrolithotripsy. The inefficiency of hemostatic therapy is an indication for superselective embolization of the renal vessels. This technique demonstrates the high efficiency in case of postoperative bleeding. AIM: To develop a treatment algorithm and to evaluate an efficiency of superselective embolization of the renal vessels, based on the results of treatment of postoperative complications, which are associated with bleeding. MATERIALS AND METHODS: A retrospective analysis of 1375 patients treated from January 2011 to December 2018 for large (over 1.5 cm) and staghorn renal stones was performed. A number of patients had various complications in the early postoperative period, which were graded according to the Clavien-Dindo classification, including bleeding due to intraoperative damage to renal vessels, which required additional interventions. The treatment strategy was based on the assessment of volume and severity of blood loss as well as the hemodynamic stability. RESULTS: Based on the severity of bleeding and hemodynamic stability, the treatment algorithm was developed. The analysis of the results of superselective embolization of renal arteries demonstrates the high effectiveness of this technique in case of postoperative bleeding. CONCLUSION: Superselective embolization is an effective method of hemostasis in case of postoperative bleeding. The proposed algorithm allows for early coordination of therapeutic measures depending on the severity of bleeding and the patients condition in order to evaluate the risk of continued bleeding and the determine the optimal treatment strategy.