Renal function, endotoxicosis, and oxidative stress in patients after open and laparoscopic nephrectomy

Abstract

BACKGROUND: Renal cell cancer is accompanied by the development of a disorder of renal function. The parameters of homeostasis after nephrectomy in renal cell cancer are not well understood.

AIM: The aim of the study is to compare the kidney functional status and parameters of homeostasis in patients with RCC after nephrectomy performed by open and laparoscopic surgery.

MATERIALS AND METHODS: Eighty patients with renal cell cancer Т3N0M0 were randomized according to the surgery into the comparison group with open nephrectomy (n = 40; 50,1 ± 3,4 years old; 18 males, 22 females) and the main group with laparoscopic nephrectomy (n = 40; 52,4 ± 5,1 years old; 16 males, 24 females). The control group was comprises from twenty subjects without urological pathology, 22–58 years old, 10 males, 10 females. Laboratory parameters of endotoxicosis, lipid peroxidation, kidney functional status, partial kidney functions, and urinary syndrome were assessed on the 1^st, 3^rd, 6^th and 10^th days after the surgery.

RESULTS: The early postoperative period of nephrectomy in renal cell cancer is accompanied by the development of endotoxicosis, activation of lipid peroxidation, deterioration of the functional state of the remaining kidney, and the formation of chronic kidney disease. At the same time, both systemic indicators (toxicity index, as well as concentrations of medium-weight molecules, diene conjugates, malondialdehyde), and renal parameters (glomerular filtration rate, albumin-creatinine ratio) are associated with the method of surgery: with a laparoscopic approach, changes in these indicators are reversible and less pronounced than with open nephrectomy.

CONCLUSIONS: The present study demonstrates the advantage of laparoscopic nephrectomy compared to open nephrectomy in patients with renal cell cancer.

Keywords

renal cell cancer / nephrectomy / endotoxicosis / lipid peroxidation / oxidative stress / glomerular filtration rate / albumin-creatinine ratio

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