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Background. Malignant neoplasms are widespread, and the ambiguous relationship between them and hyperglycemia emphasizes the importance of studying them. On the one hand, diabetes mellitus and prediabetes increase the risk of developing malignant tumors. On the other hand, malignant tumors and drugs intended for their treatment can lead to hyperglycemia. Regardless of the origin, diabetes mellitus and prediabetes may develop diabetic nephropathy. Aim of study: to analyze the functional state of the kidneys in patients with diabetes mellitus and prediabetes with kidney neoplasms.Object and methods. There was a study of 141 patients with a kidney tumor who underwent nephrectomy. For histological examination, a fragment of the kidney parenchyma was taken at a distance of at least 4 cm from the tumor. Histochemical stains, immunofluorescence reaction and electron microscopy were performed. Assessment of laboratory parameters was carried out before the surgical treatment, 3 days, 3 months, six months and a year after the operation. Parameters such as the level of protein in the urine, the presence and number of altered erythrocytes in the urine, and the glomerular filtration rate were assessed using the CKD-EPI formula.Result. Diabetic nephropathy was detected in 44 patients (31.2%). Diabetes mellitus was previously diagnosed in 10 patients (22.7%), prediabetes was diagnosed in 34 patients (77.3%). After nephrectomy, patients with prediabetes and type 2 diabetes mellitus showed a sharp decrease in glomerular filtration rate (GFR). In the subsequent period, in patients with type 2 diabetes, there is a stable decrease in GFR. In patients with prediabetes, hyperfiltration is observed within six months, however, a year after the operation, GFR decreases again.Conclusion. Widespread diabetic nephropathy in patients, it is advisable to jointly manage patients with an oncologist, nephrologist, endocrinologist, clinical pharmacologist.
Background. Malignant neoplasms are widespread, and the ambiguous relationship between them and hyperglycemia emphasizes the importance of studying them. On the one hand, diabetes mellitus and prediabetes increase the risk of developing malignant tumors. On the other hand, malignant tumors and drugs intended for their treatment can lead to hyperglycemia. Regardless of the origin, diabetes mellitus and prediabetes may develop diabetic nephropathy. Aim of study: to analyze the functional state of the kidneys in patients with diabetes mellitus and prediabetes with kidney neoplasms.Object and methods. There was a study of 141 patients with a kidney tumor who underwent nephrectomy. For histological examination, a fragment of the kidney parenchyma was taken at a distance of at least 4 cm from the tumor. Histochemical stains, immunofluorescence reaction and electron microscopy were performed. Assessment of laboratory parameters was carried out before the surgical treatment, 3 days, 3 months, six months and a year after the operation. Parameters such as the level of protein in the urine, the presence and number of altered erythrocytes in the urine, and the glomerular filtration rate were assessed using the CKD-EPI formula.Result. Diabetic nephropathy was detected in 44 patients (31.2%). Diabetes mellitus was previously diagnosed in 10 patients (22.7%), prediabetes was diagnosed in 34 patients (77.3%). After nephrectomy, patients with prediabetes and type 2 diabetes mellitus showed a sharp decrease in glomerular filtration rate (GFR). In the subsequent period, in patients with type 2 diabetes, there is a stable decrease in GFR. In patients with prediabetes, hyperfiltration is observed within six months, however, a year after the operation, GFR decreases again.Conclusion. Widespread diabetic nephropathy in patients, it is advisable to jointly manage patients with an oncologist, nephrologist, endocrinologist, clinical pharmacologist.
Background. Malignant neoplasms, including those of the kidneys, are widespread in the world. The main treatment for kidney tumors is surgery, one of its options is nephrectomy. Malignant tumors of various localizations can lead to a variety of kidney damage. Glomerulopathies of various origins are often asymptomatic, and therefore, patients do not seek medical help. For the diagnosis of glomerulopathies, it is necessary to assess morphological changes with the formulation of an immunofluorescence reaction and electron microscopy.The aim: to analyze the clinical manifestations, frequency and structure of glomerulopathies in kidney neoplasms.Patients and Methods. The study included 141 patients. The patients underwent nephrectomy, the daily protein loss, the number of altered erythrocytes in the urine, the level of creatinine in the blood serum were determined, and the glomerular filtration rate (CKD-EPI) was calculated. Morphological evaluation of samples included immunofluorescence reaction and electron microscopy. To assess the statistical significance of the relationship between variables, Spearman's nonparametric rank correlation coefficient (Rs) was calculated. The results obtained were considered significant at p<0.05. RESULTS. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies. CONCLUSION. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist Keywords: tumor, glomerulonephritis, diabetic nephropathy, glomerular filtration rate> ˂ 0.05.Results. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies.Conclusion. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist.
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