rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2410-1893-2021-8-3-9rpmj-681Research ArticleОбзорыReviewРоль биомаркеров острого повреждения почек в прогнозировании функциональных результатов хирургического лечения у больных локализованным раком почкиThe role of biomarkers of acute kidney injury in predicting functional outcomes of surgical treatment of patients with localized kidney cancerhttps://orcid.org/0000-0003-2780-9822ДементьевИ. О.DementevI. O.

Дементьев Иван Олегович – врач-уролог, младший научный сотрудник отделения лучевого и хирургического лечения урологических заболеванийс группой брахитерапии, SPIN: 7526-3821, AuthorID: 555587

249036,  г. Обнинск, ул. Королева, д. 4

Ivan O. Dementev* – junior research associate of the Department of radiation and surgical treatment of urological diseases with the group of brachytherapy, SPIN: 7526-3821, AuthorID: 555587

4 Korolev str., Obninsk 249036

dementevio@mail.ruhttps://orcid.org/0000-0002-4171-6211НюшкоК. М.NyushkoK. M.

Нюшко Кирилл Михайлович – д.м.н., ведущий научный сотрудник отделения онкоурологии ; заведующий отделом онкологии репродуктивных органов, SPIN: 7162-5527, AuthorID: 651466

249036,  г. Обнинск, ул. Королева, д. 4; 125284, г. Москва, 2-й Боткинский проезд, д. 3

Kirill M. Nyushko – Dr. Sci. (Med.), leading researcher of the oncourology Department ; head of the Department of oncology of reproductive organs, SPIN: 7162-5527, AuthorID: 651466

4 Korolev str., Obninsk 249036; 3 2nd Botkinskiy travel, Moscow 125284

kirandja@yandex.ruhttps://orcid.org/0000-0002-6112-2840КарякинО. Б.KaryakinO. B.

Карякин Олег Борисович – д.м.н., профессор, заведующий отделением лучевого и хирургического лечения урологических заболеваний с группой брахитерапии, SPIN: 1486-9379, AuthorID: 339511

249036,  г. Обнинск, ул. Королева, д. 4

Oleg B. Karyakin – Dr. Sci. (Med.), professor, honored scientist of the Russian Federation, head of the Department of radiation and surgical treatment of urologicaldiseases with the group of brachytherapy, SPIN: 1486-9379, AuthorID: 339511

4 Korolev str., Obninsk 24903

karyakin@mrrc.obninsk.ruhttps://orcid.org/0000-0002-8711-4937ЧайковВ. С.ChaikovV. S.

Чайков Владимир Сергеевич – врач-онколог, научный сотрудник отделения лучевого и хирургического лечения урологических заболеваний сгруппой брахитерапии, SPIN: 2612-7198, AuthorID: 777828

249036,  г. Обнинск, ул. Королева, д. 4

Vladimir S. Chaikov – oncologist, researcher at the Department of radiation and surgical treatment of urological diseases with the group of brachytherapy, SPIN: 2612-7198, AuthorID: 777828

4 Korolev str., Obninsk 24903

dementevio@mail.ruhttps://orcid.org/0000-0001-7025-5365ТрояновА. В.TroyanovA. V.

Троянов Алексей Владимирович – врач-онколог отделения лучевого и хирургического лечения урологических заболеваний с группой брахитерапии, SPIN: 4504-1800, AuthorID: 905540

249036,  г. Обнинск, ул. Королева, д. 4

Aleksey V. Troyanov – oncologist at the Department of radiation and surgical treatment of urological diseases with the group of brachytherapy, SPIN: 4504-1800, AuthorID: 905540

4 Korolev str., Obninsk 24903

dementevio@mail.ruhttps://orcid.org/0000-0001-5988-8268ЗаборскийИ. Н.ZaborskiiI. N.

Заборский Иван Николаевич – врач-онколог, научный сотрудник отделения лучевого и хирургического лечения урологических заболеванийс группой брахитерапии, SPIN: 2445-5967, AuthorID: 904809

249036,  г. Обнинск, ул. Королева, д. 4

Ivan N. Zaborskii – researcher at the Department of radiation and surgical treatment of urological diseases with the group of brachytherapy, SPIN: 2445-5967, AuthorID: 904809

4 Korolev str., Obninsk 24903

dementevio@mail.ruhttps://orcid.org/0000-0001-5431-8696ЩукинаЕ. О.ShchukinaE. O.

Щукина Елизавета Олеговна – клинический ординатор 

249036,  г. Обнинск, ул. Королева, д. 4

Elizaveta O. Shchukina – clinical resident 

4 Korolev str., Obninsk 24903

dementevio@mail.ruМРНЦ им. А.Ф.Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава РоссииРоссияA.F.Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological CenterRussian FederationМРНЦ им. А.Ф.Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава России; МНИОИ им. П.А.Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России,РоссияA.F.Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological Center; P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreRussian Federation2021230920218397107Copyright © Дементьев И.О., Нюшко К.М., Карякин О.Б., Чайков В.С., Троянов А.В., Заборский И.Н., Щукина Е.О., 20212021Дементьев И.О., Нюшко К.М., Карякин О.Б., Чайков В.С., Троянов А.В., Заборский И.Н., Щукина Е.О.Dementev I.O., Nyushko K.M., Karyakin O.B., Chaikov V.S., Troyanov A.V., Zaborskii I.N., Shchukina E.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/681

В настоящее время благодаря динамичному развитию хирургических технологий расширяются показания к органосохраняющему лечению рака почки. Острое повреждение почек – это серьезное осложнение, приводящее к хронической болезни почек, повышению послеоперационной смертности, ухудшению отдаленных функциональных результатов и увеличению сроков госпитализации. На сегодняшний день известно, что даже незначительное повреждение почек или нарушение их функции, проявляющееся уменьшением диуреза и нарушением биохимических показателей крови, влечет за собой серьезные клинические последствия и ассоциировано с неблагоприятным прогнозом. Повреждающие факторы при воздействии на почку изначально индуцируют молекулярные изменения, которые влекут за собой выработку определенных биомаркеров и только после этого развиваются клинические проявления поражения почек. Причины острого почечного повреждения могут быть различными, начиная от специфических почечных нарушений (острый интерстициальный нефрит, сосудистые и гломерулярные поражения, преренальная азотемия, обструктивные нарушения) и заканчивая токсическими повреждениями, непосредственно травмой и хирургическим лечением. Развитие острого почечного повреждения в послеоперационном периоде является серьезным осложнением хирургического лечения заболеваний почек, согласно данным различных авторов, частота его возникновения варьируется от 5,5 % до 34 %. Активное изучение данной проблемы позволило найти специфические биомаркеры, которые позволяют прогнозировать и диагностировать острое почечное повреждение в ранние сроки, оптимизировать тактику лечения, снизить частоту послеоперационных осложнений и сократить сроки послеоперационной реабилитации. На сегодняшний день, наиболее изученными биомаркерами острого повреждения почек (ОПП) являются цистатин С, липокалин‑2, ассоциированный с нейтрофильной желатиназой (NGAL), печеночный протеин L-FABP, KIM‑1 (Kidney injury molecule‑1), Интерлейкин -18. Дальнейшее изучение биомаркеров ОПП позволит определить среди них наиболее значимый для последующего применения в повседневной практике.

Currently, due to the dynamic development of surgical technologies, indications for organ-sparing treatment of kidney cancer are expanding. Acute kidney injury is a serious complication that leads to chronic kidney disease, increased postoperative mortality, deterioration of long-term functional outcomes, and increased hospitalization. At present, it is known that even a slight damage to kidneys or their impairment, presented by a decreased urine output and change in blood biochemical parameters, entails serious clinical consequences and is associated with a poor prognosis. Damaging factors, when the kidney is exposed, initially induce molecular changes, which entail the production of certain biomarkers, and only after that clinical aspects of kidney damage develop. The causes of acute kidney injury can be different, from specific renal disorders (acute interstitial nephritis, vascular and glomerular lesions, prerenal azotemia, obstructive disorders) to toxic damages, direct trauma and surgical treatment. The development of acute renal injury in the postoperative period is a serious complication of the surgical treatment of kidney disease, and, according to various authors, the frequency of its occurrence varies from 5.5 % to 34 %. An active study of this problem made it possible to find specific biomarkers that give the possibility to predict and diagnose acute renal injury in the early stages, to optimize the treatment strategy, to reduce the incidence of postoperative complications, and to shorten the period of postoperative rehabilitation. Currently, the most studied of acute kidney injury (AKI) biomarkers are cystatin C, neutrophil gelatinase-associated lipocalin‑2 (NGAL), hepatic protein L-FABP, KIM‑1 (Kidney injury molecule‑1), Interleukin – 18. Further study of AKI biomarkers will make it possible to determine the most significant ones for subsequent use in everyday practice

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The authors declare that there are no conflicts of interest present.