%0 Journal Article
%T Advanced Prediction of Acute Renal Damage in Patients with Polytrauma (Combined Trauma)
%A M H Makhov
%J Urology and Nephrology Journal | Open Access Journal | Peer Reviewed Journal
%D 2018
%R 10.15226/2473-6430/4/1/00140
%X The purpose of the study was to determine the early diagnostic criteria for acute renal damage in patients with combined trauma by introducing a cystatin C serum biomarker into the survey plan for the affected patients. Materials and Methods: The study of 42 patients received combined trauma from 2015 to 2016 was earned out. The biomaterial for determining the level of cystatin §³ was serum of blood. The blood sampling was carried out at 1-st, 3-rd, 7-th, 14-th days from the time of trauma. Men predominated among the aggrieved (80%), who were 4 times more than women. The Reberg-Tareev test was used to assess the filtration - reabsorption function of the kidneys. For the all patients from the group of examined were determined the following indicators: the blood creatinine, the creatinine of urine, urine quantity per 1 hour, minute diuresis, glomerular filtration, tubular reabsorption, amount of allotted urine per day. Results and Discussion: In the course of the survey, it was revealed that in 40 (95.3%) patients, the Reberg-Tareev test was within normal limits. Whereas in 2 (4.7%) the indicators were below the normative values, which was associated with the development of a clinic for acute renal failure. In 2 examined patients the acute renal failure developed on the sixth to seventh day after an injury. The glomerular filtration rate was determined by the Reberg-Tareev test and by cystatin C. In the course of the study, it was revealed that the overwhelming majority of patients with combined trauma had a normal level serum creatinine (38 people). The level of cystatin §³ serum in 33 (78.6%) of the aggrieved more than 30% had higher than the normal values. At that, an increase in the level of cystatin §³ was observed in the first 3 days, then the gradual decrease of his occurred. The glomerular filtration rate according to the Reberg-Tareev test was reduced only in 4 patients, while in the calculation according to the Hawke formula, it was affected in 33 patients. From the 42 patients on the third day from the moment of trauma in 12, based on an increase in the serum cystatin §³ in the 0.92-2 mg /1 range - 19-49 years and 1.02-2 mg /1 -> 50 years, was diagnosed subclinical acute kidney damage. Wherein, the parameters of azotemia in this group of patients were within the norm. The based on the above data, it is seen that the glomerular filtration rate is reliably lower in serum cystatin §³ than in serum creatinine, which indicates a hidden renal dysfunction and subclinical acute kidney damage. Keywords: combined trauma; cystatin C; acute renal failure;
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