Introduction. Renal malignancies accounted for 3.9% of all malignant neoplasms in Russia in 2019 and were among the top ten most common. Paraneoplastic syndrome can occur in malignant neoplasms and manifest as paraneoplastic nephropathies and glomerulopathies. The aim of the study was to analyze archival renal specimens to assess the incidence of glomerulopathies in renal neoplasms. Materials and methods. We analyzed 122 kidney samples with a tumor after nephrectomy in Krasnoyarsk regional clinical oncologic hospital named after A.I. Kryzhanovsky. To assess the cellular composition of the glomeruli and basement membrane structure, the following histochemical stains were used: PAS reaction, Masson’s trichrome stain, methenamine silver, and congo red stain. Results. The age of the patients ranged from 28 to 84 years. Malignant neoplasms were diagnosed in 114 cases (93.4%), whereas benign neoplasms were detected in 8 patients (6.6%). Fifty-six cases (45.9%) showed glomerulopathies. In 55 cases, glomerulopathies were found in malignant neoplasms (98.2%) and one case was found in a patient with a benign neoplasm (1.8%). Diabetic nephropathy was detected in 43 cases, ac-counting for 76.8%. Glomerulonephritis was diagnosed in 7 patients (12.5%) and focal segmental glomerulosclerosis was revealed in 6 cases (10.7%). Conclusion. Glomerulopathies in renal tumors are rather common and therefore their diagnosis is important in the study of the operative material. Keywords: kidney, tumour, glomerulopathies, paraneoplastic syndrome, diabetic nephropathy, glomerulonephritis
Background. According to foreign and domestic authors, a kidney cyst is one of the most common urological diseases and accounts for up to 2050%. Aim. To evaluate the results of various methods of surgical treatment of patients with kidney cysts. Materials and methods. An analysis was made of 124 case histories of patients who underwent inpatient treatment for symptomatic kidney cysts at the urology department of the Regional Clinical Hospital for the period 2016 to 2019. Also, an analysis of 50 case histories of patients who were hospitalized with the same diagnosis on the basis of the urological department of the emergency hospital for the same period. Results. Puncture methods of treatment were used only in patients whose cysts radiologically corresponded to categories I and II according to Bosniak. On the basis of the urological department of the emergency hospital, 50 people were operated on in this way, of which 22 (44%) women and 28 (56%) men. The mean age of the patients was 58.25 years. Punctures of cysts with evacuation of contents without sclerotherapy 3 (6%) cases, and puncture of cysts with sclerotherapy with 96% ethyl alcohol 47 (94%) cases. The average age of patients who underwent surgery in the regional hospital was 56.612 years. According to MSCT, cysts of category I according to Bosniak were diagnosed in 96 patients (77.4%), category II in 11 (8.9%), category IIF in 11 patients (8.9%), category III in 6 (4.8%). Laparoscopic excision of the cyst wall was performed in most cases 109 (88%), laparoscopic nephrectomy was performed in 1 case (0.8%), laparoscopic nephrectomy in 10 (8%) cases, retroperitoneoscopic excision of the cyst wall 1 (0.8%), open intervention by lumbotomy access 3 (2.4%), of which nephrectomy was performed in two patients, one patient underwent kidney resection. Conclusion. Surgical treatment of symptomatic kidney cysts was justified and necessary, as evidenced by the relief of symptoms and verification of cysts suspicious in terms of the likelihood of oncological pathology. Puncture methods of drainage and sclerotherapy are less radical, but justified in patients with high surgical risk. Excision of a cyst or resection of a kidney by laparoscopic access is an effective method of treatment that meets modern safety requirements for treatment.
Objective: to evaluate the early and long-term outcomes of cadaveric kidney allotransplantation (CKAT) based on a retrospective analysis of 71 cases treated at Krasnoyarsk Regional Clinical Hospital (KRCH).Materials and methods. From March 2014 to June 2019, 71 kidney transplants were performed at KRCH – 42 (59.15%) men and 29 (40.85%) women. The age of the patients varied from 20 to 59 years (mean age 39.6 ± 8.14 years). The causes of end-stage chronic kidney disease which subsequently led to CKAT were chronic glomerulonephritis, chronic tubulointerstitial nephritis, hypertensive nephropathy (HN), diabetic nephropathy resulting from type I diabetes (DN), nephropathy of mixed genesis (HN + DN), vesicoureteral reflux, congenital angiodysplasia of the kidneys, and Alport syndrome. The mean number of HLA mismatches was 4.5 ± 0.9.Results. Hospitalization lasted for an average of 34.05 ± 9.56 days. Primary function was observed in 32 (45.08%) patients, while 39 (54.92%) cases had delayed function. Post-transplant complications were noted in 23 (32.39%) patients, of whom 12 (16.9%) had early post-transplant complications, while 15 (21.13%) encountered complications in the late post-transplant period. The most frequently diagnosed were immunological, infectious, and urological complications. Vascular, surgical, oncological, and other complications were less frequent. The annual graft survival rate was 87.3%. Patient survival rate was 95.77%. One (1.4%) and 2 (2.81%) patients died in the early and late post-transplant periods, respectively. Hospital mortality – 1 case (1.4%).Conclusion. Kidney transplantation is the most effective treatment for patients with irreversible chronic kidney disease. About 87.33% of transplants were found to be effective. However, 32.39% of patients had postoperative complications. The vast majority of complications were reversible and were corrected conservatively or surgically. Nevertheless, graft loss occurred in 12.67% of cases. The success of transplantation depends on a number of factors related to both the donor and the recipient, as well as the immunological status and surgical technique. A personalized approach to recipients helps to reduce postoperative complications, prevent nephrotoxicity and rejection reactions.
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