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Hypertensive nephropathy as an outcome of unilateral nephrectomy in kidney cancer
- Authors: Titjaev I.I.1, Andreev S.S.1,2, Andreeva S.V.1, Udalov K.V.1,2, Kas’janov D.S1
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Affiliations:
- City Clinical Hospital No. 1
- Novosibirsk State Medical University of the Ministry of Healthcare of the Russian Federation
- Issue: Vol 10, No 3 (2020)
- Pages: 229-234
- Section: Original articles
- URL: https://journals.eco-vector.com/uroved/article/view/42529
- DOI: https://doi.org/10.17816/uroved42529
- ID: 42529
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Abstract
Aim. To study the adaptive mechanisms of structural and functional changes in a single kidney after nephrectomy for kidney cancer.
Materials and Methods. A total of 179 operations of two types were performed: nephrectomy and kidney resection in patients with cancerous lesions. Postoperative ultrasound was performed – size control and dopplerography of the vessels of the contralateral single kidney, monitoring-control of blood pressure.
Results. In case of kidney resection, the adaptive mechanisms controlling the volume of functioning tissue are preserved. The load on the organ remains minimal and physiological, and is not redistributed, blood pressure remains close to baseline. Nephrectomy does not lead to functional changes in a single kidney, but to adaptive and pathophysiological structural damage as a result of increased plasma pressure, organ “reboot”, its vicarious hypertrophy, which is accompanied by venous edema of interstitium as a pressure factor on the tissue, increased tone of arterioles, the development of secondary organ ischemia, circulatory hypoxia and increased blood pressure. All this fits into the clinical picture of hypertensive nephropathy.
Conclusions. The potential risk of hypertension and hypertensive nephropathy in patients undergoing nephrectomy, compared with patients after organ-saving surgery, is significantly higher. One of the most important manifestations of hypertension in the elderly is a violation of the structure and function of “target organs”, which include: the brain, heart, blood vessels, kidney. Nephrectomy forms a pathological vicious circle, contributing to the development and further progression of renal and cardiovascular failure.
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About the authors
Igor I. Titjaev
City Clinical Hospital No. 1
Email: den-sk@ya.ru
Doctor of Medical Science, Professor, Urologist of Urology Department
Russian Federation, NovosibirskSergey S. Andreev
City Clinical Hospital No. 1; Novosibirsk State Medical University of the Ministry of Healthcare of the Russian Federation
Author for correspondence.
Email: andreev723@ya.ru
Head of Urology Department; Assistant of Department of Urology
Russian Federation, NovosibirskSvetlana V. Andreeva
City Clinical Hospital No. 1
Email: andreev723@ya.ru
Head of the Department of Ultrasound Diagnostics
Russian Federation, NovosibirskKonstantin V. Udalov
City Clinical Hospital No. 1; Novosibirsk State Medical University of the Ministry of Healthcare of the Russian Federation
Email: k.udalov@mail.ru
Head of Oncourology Department; Assistant of Department of Urology
Russian Federation, NovosibirskDenis S Kas’janov
City Clinical Hospital No. 1
Email: kasyanovds@mail.ru
Urologist, Oncologist of the Outpatient Care Center
Russian Federation, NovosibirskReferences
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