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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rpmj</journal-id><journal-title-group><journal-title xml:lang="ru">Research'n Practical Medicine Journal</journal-title><trans-title-group xml:lang="en"><trans-title>Research and Practical Medicine Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2410-1893</issn><publisher><publisher-name>"QUASAR", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17709/2410-1893-2023-10-2-10</article-id><article-id custom-type="edn" pub-id-type="custom">OOLQTS</article-id><article-id custom-type="elpub" pub-id-type="custom">rpmj-888</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Review</subject></subj-group></article-categories><title-group><article-title>Острое повреждение почек в хирургии рака почки: патогенез, терапия ранних и поздних осложнений</article-title><trans-title-group xml:lang="en"><trans-title>Perioperative acute kidney injury in surgical treatment of renal cancer: pathogenesis, therapy of early and late complications</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2767-7153</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попов</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Popov</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Попов Сергей Валерьевич – д.м.н., заслуженный врач Российской Федерации, врач-уролог, главный врач, руководитель Городского центра эндоскопической урологии и новых технологий СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-2767-7153" ext-link-type="uri">https://orcid.org/0000-0003-2767-7153</ext-link>, SPIN: 3830-9539, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=211507" ext-link-type="uri">211507</ext-link>, Scopus Author ID: 57197368945, ResearcherID: G-3819-2015</p></bio><bio xml:lang="en"><p> </p><p>Sergey V. Popov – Dr. Sci. (Medicine), Honored Doctor of the Russian Federation, urologist, Chief Physician, Head of the City Center for Endoscopic Urology and New Technologies, Clinical Hospital of Saint-Luca, Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-2767-7153" ext-link-type="uri">https://orcid.org/0000-0003-2767-7153</ext-link>, SPIN: 3830-9539, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=211507" ext-link-type="uri">211507</ext-link>, Scopus Author ID: 57197368945, ResearcherID: G-3819-2015</p></bio><email xlink:type="simple">doc.popov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9935-0243</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гусейнов</surname><given-names>Р. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Guseynov</surname><given-names>R. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Гусейнов Руслан Гусейнович – к. м. н., врач-уролог, онколог, нефролог, заместитель главного врача по научной деятельности, СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация; ассистент кафедры госпитальной хирургии медицинского факультета ФГБОУ ВО «Санкт-Петербургский государственный университет», Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0001-9935-0243" ext-link-type="uri">https://orcid.org/0000-0001-9935-0243</ext-link>, SPIN: 4222-4601, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=1083364" ext-link-type="uri">1083364</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=57209859097" ext-link-type="uri">57209859097</ext-link>, <ext-link xlink:href="https://publons.com/researcher/ABC-6397-2021" ext-link-type="uri">ResearcherID: ABC-6397-2021</ext-link></p></bio><bio xml:lang="en"><p> </p><p>Ruslan G. Guseynov – Cand. Sci. (Medicine), urologist, oncologist, nephrologist, Deputy Chief Physician for Scientific Activity, Clinical Hospital of Saint-Luca, Saint Petersburg, Russian Federation; Hospital Surgery Department assistant at the Medical Institute, St. Petersburg University, Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0001-9935-0243" ext-link-type="uri">https://orcid.org/0000-0001-9935-0243</ext-link>, SPIN: 4222-4601, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=1083364" ext-link-type="uri">1083364</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=57209859097" ext-link-type="uri">57209859097</ext-link>, <ext-link xlink:href="https://publons.com/researcher/ABC-6397-2021" ext-link-type="uri">ResearcherID: ABC-6397-2021</ext-link></p></bio><email xlink:type="simple">rusfa@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Помешкин</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pomeshkin</surname><given-names>Ye. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Помешкин Евгений Владимирович – к.м.н., врач-уролог, заведующий урологическим отделением №2 СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация</p><p>SPIN: 5661-1947, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=910313" ext-link-type="uri">910313</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=36671852200" ext-link-type="uri">36671852200</ext-link></p></bio><bio xml:lang="en"><p> </p><p>Yevgeni V. Pomeshkin – Cand. Sci. (Medicine), urologist, Head of the Urological Department No. 2, Clinical Hospital of Saint-Luca, Saint Petersburg, Russian Federation</p><p>SPIN: 5661-1947, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=910313" ext-link-type="uri">910313</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=36671852200" ext-link-type="uri">36671852200</ext-link></p></bio><email xlink:type="simple">info@lucaclinic.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4064-5033</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сивак</surname><given-names>К. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sivak</surname><given-names>K. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Сивак Константин Владимирович – к.б.н., ведущий научный сотрудник, СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-4064-5033" ext-link-type="uri">https://orcid.org/0000-0003-4064-5033</ext-link>, SPIN: 7426-8322, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=546323" ext-link-type="uri">546323</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=35269910300" ext-link-type="uri">35269910300</ext-link>, ResearcherID: ABC-6724-2021</p></bio><bio xml:lang="en"><p> </p><p>Konstantin V. Sivak – Cand. Sci. (Biology), Leading Research Fellow, Clinical Hospital of Saint-Luca, Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-4064-5033" ext-link-type="uri">https://orcid.org/0000-0003-4064-5033</ext-link>, SPIN: 7426-8322, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=546323" ext-link-type="uri">546323</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=35269910300" ext-link-type="uri">35269910300</ext-link>, ResearcherID: ABC-6724-2021</p></bio><email xlink:type="simple">kvsivak@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7656-4473</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Перепелица</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Perepelitsa</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Перепелица Виталий Владимирович – к.м.н., врач-уролог СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0002-7656-4473" ext-link-type="uri">https://orcid.org/0000-0002-7656-4473</ext-link>, SPIN: 7445-1996, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=1125078" ext-link-type="uri">1125078</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=14823999900" ext-link-type="uri">14823999900</ext-link>, ResearcherID: ABF-8396-2021</p></bio><bio xml:lang="en"><p> </p><p>Vitaliy V. Perepelitsa – Cand. Sci. (Medicine), urologist, Clinical Hospital of Saint-Luca, Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0002-7656-4473" ext-link-type="uri">https://orcid.org/0000-0002-7656-4473</ext-link>, SPIN: 7445-1996, AuthorID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=14823999900" ext-link-type="uri">1125078</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=14823999900" ext-link-type="uri">14823999900</ext-link>, ResearcherID: ABF-8396-2021</p></bio><email xlink:type="simple">perepelitsa_vit@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4453-2204</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Надеин</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nadein</surname><given-names>K.  A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Надеин Константин Александрович – д.б.н., научный сотрудник научного отдела СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-4453-2204" ext-link-type="uri">https://orcid.org/0000-0003-4453-2204</ext-link>, SPIN: 6574-3837, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=391878" ext-link-type="uri">391878</ext-link></p><p> </p></bio><bio xml:lang="en"><p>Konstantin A. Nadein – Dr. Sci. (Biology), Researcher of the Scientific Department, Clinical Hospital of Saint‑Luca, Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-4453-2204" ext-link-type="uri">https://orcid.org/0000-0003-4453-2204</ext-link>, SPIN: 6574-3837, AuthorID: <ext-link xlink:href="https://orcid.org/0000-0003-4453-2204" ext-link-type="uri">391878</ext-link>, ResearcherID: ААН-7006-2021</p></bio><email xlink:type="simple">info@lucaclinic.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4331-028X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Буненков</surname><given-names>Н. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Bunenkov</surname><given-names>N. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Буненков Николай Сергеевич – к.м.н., научный сотрудник научного отдела СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация; хирург ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. И. П. Павлова», Санкт-Петербург, Российская Федерация; лаборант НИЛ патологии малого круга кровообращения ФГБУ «Национальный медицинский исследовательский центр им. В. А. Алмазова» Министерства здравоохранения Российской Федерации, Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-4331-028X" ext-link-type="uri">https://orcid.org/0000-0003-4331-028X</ext-link>, SPIN: 3611-1290, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=884269" ext-link-type="uri">884269</ext-link>, Scopus Author ID:<ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=57191173503" ext-link-type="uri"> 57191173503</ext-link> </p></bio><bio xml:lang="en"><p> </p><p>Nikolai S. Bunenkov – Cand. Sci. (Medicine), Researcher of the Scientific Department, Clinical Hospital of Saint-Luca, Saint Petersburg, Russian Federation; surgeon, Pavlov First Saint Petersburg State Medical University (Pavlov University), Saint Petersburg, Russian Federation; Laboratory Assistant at the SL for Pathologies of the Small Circle of Blood Circulation, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-4331-028X" ext-link-type="uri">https://orcid.org/0000-0003-4331-028X</ext-link>, SPIN: 3611-1290, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=884269" ext-link-type="uri">884269</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=57191173503" ext-link-type="uri">57191173503</ext-link>, ResearcherID: D-3211-2015</p></bio><email xlink:type="simple">bunenkov2006@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3011-1812</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Улитина</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Ulitina</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p> </p><p>Улитина Анна Сергеевна – к.м.н., старший научный сотрудник СПб ГБУЗ «Клиническая больница Святителя Луки», Санкт-Петербург, Российская Федерация; старший научный сотрудник отдела молекулярно-генетических и нанобиологических технологий научно-исследовательского центра ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. И. П. Павлова», Санкт-Петербург, Российская Федерация</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-3011-1812" ext-link-type="uri">https://orcid.org/0000-0003-3011-1812</ext-link>, SPIN: 3895-7799, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=153529" ext-link-type="uri">153529</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=12782379400" ext-link-type="uri">12782379400</ext-link></p></bio><bio xml:lang="en"><p> </p><p>Anna S. Ulitina – Cand. Sci. (Medicine), Senior Research Fellow, Clinical Hospital of Saint-Luca, Saint Petersburg; Senior Researcher at the Department of Molecular Genetic and Nanobiological Technologies of the Research Center, Pavlov First Saint Petersburg State Medical University (Pavlov University), Saint Petersburg, Russian Federation</p><p>ORCID: <ext-link xlink:href="https://orcid.org/0000-0003-3011-1812" ext-link-type="uri">https://orcid.org/0000-0003-3011-1812</ext-link>, SPIN: 3895-7799, AuthorID: <ext-link xlink:href="https://elibrary.ru/author_profile.asp?id=153529" ext-link-type="uri">153529</ext-link>, Scopus Author ID: <ext-link xlink:href="https://www.scopus.com/authid/detail.uri?authorId=12782379400" ext-link-type="uri">12782379400</ext-link>, ResearcherID: AGC-7993-2022</p></bio><email xlink:type="simple">anna.s.ulitina@yandex.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Клиническая больница Святителя Луки</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Hospital of Saint‑Luca</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Клиническая больница Святителя Луки; &#13;
Санкт‑Петербургский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Hospital of Saint‑Luca</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Клиническая больница Святителя Луки; &#13;
Первый Санкт‑Петербургский государственный медицинский университет им. И. П. Павлова; &#13;
Национальный медицинский исследовательский центр им. В. А. Алмазова Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Hospital of Saint‑Luca; &#13;
Pavlov First Saint Petersburg State Medical University (Pavlov University); &#13;
Almazov National Medical Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Клиническая больница Святителя Луки; &#13;
Первый Санкт‑Петербургский государственный медицинский университет им. И. П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Hospital of Saint‑Luca; &#13;
Pavlov First Saint Petersburg State Medical University (Pavlov University)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>18</day><month>05</month><year>2023</year></pub-date><volume>10</volume><issue>2</issue><fpage>104</fpage><lpage>117</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Попов С.В., Гусейнов Р.Г., Помешкин Е.В., Сивак К.В., Перепелица В.В., Надеин К.А., Буненков Н.С., Улитина А.С., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Попов С.В., Гусейнов Р.Г., Помешкин Е.В., Сивак К.В., Перепелица В.В., Надеин К.А., Буненков Н.С., Улитина А.С.</copyright-holder><copyright-holder xml:lang="en">Popov S.V., Guseynov R.G., Pomeshkin Y.V., Sivak K.V., Perepelitsa V.V., Nadein K.A., Bunenkov N.S., Ulitina A.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rpmj.ru/rpmj/article/view/888">https://www.rpmj.ru/rpmj/article/view/888</self-uri><abstract><p>Развитие острого почечного повреждения обусловлено рядом факторов как со стороны пациента (возраст, сопутствующая патология, объективный статус), так и онкологическим процессом (стадия заболевания, локализация, объем оперативного вмешательства, доступ и т.д.). Острое почечное повреждение у пациентов с раком почки после проведения оперативного лечения может сопровождаться развитием ранних (гипергидратация, нарушения электролитного баланса, гиперкалиемия, нарушения кислотно‑ основного состояния, уремическая интоксикация) и поздних (хроническая болезнь почек) осложнений. Частота развития указанных осложнений повышается с увеличением объема резекции почки, вследствие чего важными являются учет факторов риска, своевременная диагностика степени повреждения почек и проведение лечебных мероприятий, направленных на восстановление функции почек.</p><p>В настоящий момент изучают возможность использования различных молекул в качестве ранних маркеров повреждения почек, которые помогают не только оценить наличие повреждения почек, но и локализовать его. Например, альбумин, цистатин С сыворотки, альфа 1‑микроглобулин, Р2‑микроглобулин – маркеры повреждения клубочка, NGAL, KIM‑1; L‑FABP, цистатин‑ С мочи, IL‑18 – отражают повреждение проксимального канальца, GST, NGAL – дистального канальца, калибиндин D28 – характеризует повреждение собирательной трубки, остеопонтин, NHE‑3 – связаны с повреждением петли Генле. Проведение мероприятий лечебно‑ профилактического характера (инфузионной терапии, противоишемической защиты, модуляции ферроптоза, заместительной почечной терапии), а также динамическое мониторирование основных биомаркеров почечного повреждения направлено на предупреждение персистирования патологического процесса с возможным исходом в хроническую болезнь почек, что особенно нежелательно у пациентов с раком единственной почки. Основными направлениями лечебно‑п рофилактических мероприятий у пациентов с острым повреждением почек следует считать: 1) максимально быстрое устранение или минимизацию действия опухолевой ткани; 2) контроль и коррекцию жизнеугрожающих осложнений дисфункции почек (гипергидратации, нарушений электролитного баланса (гиперкалиемии), кислотно‑ основного состояния, уремической интоксикации). Способы противоишемической защиты включают в себя ряд хирургических приемов, направленных 1) на минимизацию времени ишемии, 2) на снижение интенсивности энергозависимых метаболических процессов в почке, 3) на тренировку почечной паренхимы к гипоксическим условиям (прием ишемического прекондиционирования).</p><p>Продолжительность почечной ишемии представляет собой важный модифицируемый фактор, влияющий на раннюю и отдаленную почечную функцию у пациентов, подвергшихся хирургическому воздействию.</p><p>В статье проведен анализ современных научных данных, посвященных проблеме периоперационного острого почечного повреждения в хирургии рака почки.</p></abstract><trans-abstract xml:lang="en"><p>The development of acute renal injury is due to a number of factors both on the part of the patient (age, concomitant pathology, objective status) and the oncological process (stage of the disease, localization, volume of surgical intervention, access, etc.). Acute renal injury in patients with kidney cancer after surgical treatment may be accompanied by the development of early (hyperhydration, electrolyte balance disorders, hyperkalemia, acid‑base condition disorders, uremic intoxication) and late chronic kidney disease complications. The incidence of these complications increases with an increase in the volume of kidney resection, as a result of which it is important to take into account risk factors, timely diagnosis of the degree of kidney damage and medical measures aimed at restoring kidney function. Currently, the possibility of using various molecules as early markers of kidney damage, which help not only assess the presence of kidney damage, but also localize it, is being studied. For example, albumin, serum cystatin C, alpha 1‑microglobulin, P2‑microglobulin – markers of glomerular damage, NGAL, KIM‑1; L‑FABP, urine cystatin‑C, IL‑18 – reflect damage to the proximal tubule, GST, NGAL – distal tubule, calibindin D28 ‑ characterizes damage to the collecting duct, osteopontin, NHE‑3 – are associated with damage to the loop of Henle. Measures of a curative and preventive nature (infusion therapy, anti‑ischemic protection, modulation of ferroptosis, renal replacement therapy), as well as dynamic monitoring of the main biomarkers of renal damage are aimed at preventing the persistence of the pathological process with a possible outcome into chronic kidney disease, which is especially undesirable in patients with single kidney cancer. The main directions of medical and preventive measures in patients with acute kidney injury should be considered: 1) the fastest possible elimination or minimization of the effect of tumor tissue; 2) control and correction of life‑threatening complications of renal dysfunction (hyperhydration, electrolyte balance disorders (hyperkalemia), acid‑base state, uremic intoxication). Methods of anti‑ischemic protection include a number of surgical techniques aimed at 1) minimizing ischemia time, 2) reducing the intensity of volatile metabolic processes in the kidney, 3) training renal parenchyma for hypoxic conditions (receiving ischemic preconditioning).</p><p>Duration of renal ischemia represents an important modifiable factor affecting early and distant renal function in surgically exposed patients. The article analyzes modern scientific data on the problem of postoperative acute kidney injury in renal cancer surgery.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак почки</kwd><kwd>хроническая болезнь почек</kwd><kwd>острое почечное повреждение</kwd><kwd>ферроптоз</kwd><kwd>гиперкалиемия</kwd><kwd>биомаркеры</kwd></kwd-group><kwd-group xml:lang="en"><kwd>kidney cancer</kwd><kwd>chronic kidney disease</kwd><kwd>acute kidney injury</kwd><kwd>ferroptosis</kwd><kwd>hyperkalemia</kwd><kwd>biomarkers</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Du Z, Chen W, Xia Q, Shi O, Chen Q. Trends and projections of kidney cancer incidence at the global and national levels, 1990-2030: a Bayesian age-period-cohort modeling study. 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