DIAGNOSTIC TECHNIQUE FOR ACUTE RENAL INJURY FOLLOWING ORGAN-PRESERVING SURGICAL TREATMENT OF LOCALIZED RENAL CELL CARCINOMA

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to oncology, and can be used for diagnosing acute renal damage following an organ-preserving surgical treatment of localized renal cell carcinoma. At the preoperative stage, venous blood is examined for the following values: concentration of cystatin C – symbol Z, duration of thermal kidney ischemia (TKI) – symbol Y is intraoperatively recorded. After 16 hours, the concentrations of cystatin C, L-FABP and NGAL in venous blood are measured, as well patient's diuresis rate is measured. Then, for each of the indices (X, Y, Z) a conditional numerical value is calculated in points from 0 to 1. Then by formula α=X+Y+Z total score (α) is calculated, where X=a*0.4+b*0.2+c*0.2+d*0.2, 0.4; 0.2 – weight coefficients. a=0, if in 16 hours after operation diuresis will make ≥70 ml/hour; a=1, if in 16 hours after operation diuresis will be 70 ml/hour. b=0, if in 16 hours after the surgery, blood cystatin C concentration increase is 10 %, b=1, if in 16 hours after the surgery blood cystatin C concentration increase is ≥10 %. c=0, if in 16 hours after the operation, the blood NGAL concentration increase is 10 %, c=1, if in 16 hours after the operation, the blood NGAL concentration increase is ≥10 %. d=0, if in 16 hours after the operation, the blood L-FABP concentration increase is 10 %, d=1, if the blood L-FABP concentration increase in 16 hours after the operation ≥10 %. Y=0 if duration of TKI 15 min; Y=1 if length of TKI =15–21 min. Z=0 if the blood cystatin C concentration before the operation is less than 1,000 ng/ml, Z=1 if the blood cystatin C concentration before the operation is more than 1,000 ng/ml. At value of 2.8α≤3 acute renal damage is diagnosed.;EFFECT: method provides early diagnosis of acute renal damage in the patients after kidney resection in TKI (prior to the beginning of the creatinine increase) by taking into account the length of TKI as one of the factors, since it has a significant effect on the development of acute renal damage.;1 cl, 5 tbl, 2 ex