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Журнал "Нирки" Том 12, №4, 2023

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Пошкодження нирок при опіковій хворобі. Частина 1. Патоморфофізіологія (огляд літератури)

Автори: O.V. Kravets, V.V. Yekhalov, V.V. Gorbuntsov, D.A. Krishtafor
Dnipro State Medical University, Dnipro, Ukraine

Рубрики: Нефрологія

Розділи: Довідник фахівця

Версія для друку


Резюме

Гостре пошкодження нирок (ГПН) є поширеним ускладненням у важкохворих з опіками, пов’язаними із серйозними несприятливими наслідками, включаючи збільшення тривалості перебування в стаціонарі, розвиток хронічної хвороби нирок та підвищений ризик смертності. Частота розвитку ГПН серед опікових хворих у відділеннях інтенсивної терапії становить 38 (30–46) %. Головними факторами ризику ГПН вважаються високий відсоток опіку загальної поверхні тіла та низка факторів схильності індивідуального характеру. Патофізіологічні й морфологічні зміни в організмі при поєднанні опікової хвороби та пошкодження нирок мають певні розбіжності із класичним перебігом патологічного процесу за окремих нозологічних форм. Незважаючи на значний прогрес у технологіях рідинної ресусцитації, інтенсивної терапії та замісної ниркової терапії в останні роки, рівень захворюваності та смертності у таких пацієнтів залишається досить високим. Краще розуміння клінічних характеристик, раннє виявлення та запобігання факторам ризику пошкодження нирок при опіках, а також своєчасне медичне втручання можуть у перспективі ефективно зменшити захворюваність і прогресування патологічного процесу й оптимізувати прогноз.

Acute kidney injury (AKI) is a common complication in critically ill burn patients and is associated with serious adverse outcomes, including increased length of hospital stay, development of chronic kidney disease, and increased risk of mortality. The incidence of AKI among burn patients in the intensive care units is 38 (30–46) %. A high percentage of the total burn surface area and a number of individual predisposing factors are considered to be the leading risk factors for AKI. Pathophysiological and morphological changes in the body under the combination of burn disease and kidney damage have certain discrepancies with the classical course of the pathological process in some nosological forms. Despite significant progress in the technologies of fluid resuscitation, intensive care and renal replacement therapy in recent years, the morbidity and mortality rate in such patients remain quite significant. A better understanding of clinical characteristics, early detection and prevention of risk factors for kidney damage in burns, as well as timely medical intervention can effectively reduce morbidity and progression of the pathological process, and also optimize the prognosis in the long run.


Ключові слова

огляд; гостре пошкодження нирок; опікова хвороба; хронічна хвороба нирок; патоморфологія; патофі­зіологія

review; acute kidney injury; burn disease; chronic kidney disease; pathomorphology; pathophysiology


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Список літератури

  1. Yoldaş T.K., Atalay A., Balci C. et al. Acute kidney injury in burns in the intensive care unit: A retrospective research. Ulus Travma Acil Cerrahi Derg. 2023. 29(3). 321-326. doi: 10.14744/tjtes.2022.95048.
  2. You B., Yang Z., Zhang Y. et al. Late-Onset Acute Kidney Injury is a Poor Prognostic Sign for Severe Burn Patients. Front. Surg. 2022. 2(9). 842999. doi: 10.3389/fsurg.2022.842999.
  3. Emara S.S., Alzaylai A.A. Renal failure in burn patients: a review. Ann. Burns Fire Disasters. 2013. 26(1). 12-15.
  4. Koval M., Sorokina O., Tatsyuk S. Impaired renal function in the acute period of burn disease and its prognostic value. Emergency Medicine (Ukraine). 2019. 7(102). 52-55. doi: 10.22141/2224-0586.7.102.2019.180358 (in Ukrainian).
  5. Putra O.N., Saputro I.D., Diana D. Rifle Criteria For Acute Kidney Injury In Burn Patients: Prevalence And Risk Factors. Ann. Burns Fire Disasters. 2021. 34(3). 252-258.
  6. Yang H.T., Yim H., Cho Y.S. et al. Assessment of biochemical markers in the early post-burn period for predicting acute kidney injury and mortality in patients with major burn injury: comparison of serum creatinine, serum cystatin-C, plasma and urine neutrophil gelatinase-associated lipocalin. Crit. Care. 2014. 18(4). R151. doi: 10.1186/cc13989.
  7. Chen B., Zhao J., Zhang Z. et al. Clinical characteristics and risk factors for severe burns complicated by early acute kidney injury. Burns. 2020. 46(5). 1100-1106. doi: 10.1016/j.burns.2019.11.018.
  8. Niculae A., Peride I., Tiglis M. et al. Burn-Induced Acute Kidney Injury — Two-Lane Road: From Molecular to Clinical Aspects. International Journal of Molecular Sciences. 2022. 23(15). 8712. doi: 10.3390/ijms23158712.
  9. Yekhalov V.V., Kravets O.V., Krishtafor D.A. Electric shock: a clinical lecture. Emergency Medicine (Ukraine). 2022. 18(5). 23-33. doi: 10.22141/2224-0586.18.5.2022.1507 (in Ukrainian).
  10. Koniman R., Kaushik M., Teo S.H. et al. Renal outcomes of intensive care burn patients in an Asian tertiary centre. Burns. 2020. 46(2). 400-406. doi: 10.1016/j.burns.2019.07.038.
  11. Thalji S.Z., Kothari A.N., Kuo P.C., Mosier M.J. Acute Kidney Injury in Burn Patients: Clinically Significant Over the Initial Hospitalization and 1 Year After Injury: An Original Retrospective Cohort Study. Ann. Surg. 2017. 266(2). 376-382. doi: 10.1097/SLA.0000000000001979.
  12. Clark A.T., Li X., Kulangara R. et al. Acute Kidney Injury After Burn: A Cohort Study from the Parkland Burn Intensive Care Unit. J. Burn Care Res. 2019. 40(1). 72-78. doi: 10.1093/jbcr/iry046.
  13. Folkestad T., Brurberg K.G., Nordhuus K.M. et al. Acute kidney injury in burn patients admitted to the intensive care unit: a systematic review and meta-analysis. Crit. Care. 2020. 24(1). 2. doi: 10.1186/s13054-019-2710-4.
  14. Lavrentieva A., Depetris N., Moiemen N. et al. Renal replacement therapy for acute kidney injury in burn patients, an international survey and a qualitative review of current controversies. Burns. 2022. 48(5). 1079-1091. doi: 10.1016/j.burns.2021.08.013.
  15. Duan Z., Cai G., Li J. et al. Meta-Analysis of Renal Replacement Therapy for Burn Patients: Incidence Rate, Mortality, and Renal Outcome. Front. Med. (Lausanne). 2021. 8. 708533. doi: 10.3389/fmed.2021.708533.
  16. Coca S.G., Bauling P., Schifftner T. et al. Contribution of acute kidney injury toward morbidity and mortality in burns: a contemporary analysis. Am. J. Kidney Dis. 2007. 49(4). 517-23. doi: 10.1053/j.ajkd.2006.12.018.
  17. Ushkalenko A.O. The relevance of the issue of burn disease and its complications as the main causes of mortality in burns. Actual issues of theoretical and clinical medicine: a collection of theses of reports of the International Scientific and Practical Conference of Students and Young Scientists (Sumy, April 10–12, 2013). Sumy: Sumy State University; 2013. 264-265 (in Ukrainian).
  18. Yang G., Tan L., Yao H. et al. Long-Term Effects of Severe Burns on the Kidneys: Research Advances and Potential Therapeutic Approaches. J. Inflamm. Res. 2023. 16. 1905-1921. doi: 10.2147/JIR.S404983.
  19. Schneider D.F., Dobrowolsky A., Shakir I.A. et al. Predicting acute kidney injury among burn patients in the 21st century: a classification and regression tree analysis. J. Burn Care Res. 2012. 33(2). 242-51. doi: 10.1097/BCR.0b013e318239cc24.
  20. Zhang H., Qu W., Nazzal M., Ortiz J. Burn patients with history of kidney transplant experience increased incidence of wound infection. Burns. 2020. 46(3). 609-615. doi: 10.1016/j.burns.2019.09.001.
  21. Belozorov I., Lytovchenko A., Oliynyk G. et al. Abdominal compartment syndrome in burn patients. Journal of V.N. Karazin KhNU. 2018. 36. 63-71.
  22. Talizin T.B., Tsuda M.S., Tanita M.T. et al. Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care. Rev. Bras. Ter. Intensiva. 2018. 30(1). 15-20. doi: 10.5935/0103-507x.20180001.
  23. Pinto G.C.C., Zaupa M.C., Troster E.J. Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care. Rev. Bras. Ter. Intensiva. 2019. 31(2). 271-272. doi: 10.5935/0103-507X.20190022.
  24. Ho G., Camacho F., Rogers A., Cartotto R. Early Acute Kidney Injury Following Major Burns. Journal of Burn Care & Research. 2021. 42(2). 126-34. doi: 10.1093/jbcr/iraa123.
  25. Su K., Xue F.S., Xue Z.J., Wan L. Clinical characteristics and risk factors of early acute kidney injury in severely burned patients. Burns. 2021. 47(2). 498-499. doi: 10.1016/j.burns.2020.08.018.
  26. Kim H.Y., Kong Y.G., Park J.H., Kim Y.K. Acute kidney injury after burn surgery: Preoperative neutrophil/lymphocyte ratio as a predictive factor. Acta Anaesthesiol. Scand. 2019. 63(2). 240-247. doi: 10.1111/aas.13255.
  27. Mariano F., De Biase C., Hollo Z. et al. Long-Term Preservation of Renal Function in Septic Shock Burn Patients Requiring Renal Replacement Therapy for Acute Kidney Injury. J. Clin. Med. 2021. 10(24). 5760. doi: 10.3390/jcm10245760.
  28. Oh D.J. A long journey for acute kidney injury biomarkers. Renal Failure. 2020. 42(1). 154-165. doi: 10.1080/0886022X.2020.1721300.
  29. Shapoval O.V., Komaromi N.A., Patsatsia M.M. To the Question about the Methods Used in Combustiology Practice to Assess the Condition of Patients and Predict General and Local Complications. JMBS. 2021. 6(6). 33-43. doi: 10.26693/jmbs06.06.033 (in Ukrainian).
  30. Witkowski W., Kawecki M., Surowiecka-Pastewka A. Early and Late Acute Kidney Injury in Severely Burned Patients. Med. Sci. Monit. 2016. 22. 3755-3763. doi: 10.12659/MSM.895875.
  31. Lakhtadyr T. Structural changes of the rat kidney cortical substance in the long-term period after burn injury of the skin under conditions of HAES-LX-5% infusion. Emergency Medicine (Ukraine). 2019. 5(100). 79-83. doi: 10.22141/2224-0586.5.100.2019.177023 (in Ukrainian).
  32. Sipliviy V.O., Dotsenko V.V., Petrenko H.D. et al. Burn disease. Burn treatment in a hospital depending on the period of the burn disease. Types of surgical operations used in burn treatment: methodological guidelines. Kharkiv: KhNMU; 2020. 16 (in Ukrainian).
  33. Chapman C.L., Johnson B.D., Parker M.D. et al. Kidney physiology and pathophysiology during heat stress and the modification by exercise, dehydration, heat acclimation and aging. Temperature. 2021. 8(2). 108-159. doi: 10.1080/23328940.2020.1826841.
  34. Greenhalgh D.G. Management of Burns. N. Engl. J. Med. 2019. 380. 2349-59. doi: 10.1056/NEJMra1807442.
  35. Tiron O., Vastianov R. Pathological dysfunction of parenchymal organs as a probable pathophysiological mechanism of thermal damage to the thyroid gland. Scientific Collection “InterConf+”. 2023. 34(159). 225-241. doi: 10.51582/interconf.19-20.06.2023.023 (in Ukrainian).
  36. Lachtadyr T.V. Structural changes of rat’s renal cortex in late period of skin burn injury under the conditions of the infusion by lactoprotein with sorbitol. Biomedical and Biosocial Anthropology. 2017. 28. 81-87 (in Ukrainian).
  37. Ibrahim A.E., Sarhane K.A., Fagan S.P., Goverman J. Renal dysfunction in burns: a review. Ann. Burns Fire Disasters. 2013. 26(1). 16-25.
  38. Sorokina O., Koval M. Screening and diagnosis of sepsis in severe burns. Emergency Medicine (Ukraine). 2020. 16(1). 16-23. doi: 10.22141/2224-0586.16.1.2020.196925 (in Ukrainian).
  39. Schult L., Halbgebauer R., Karasu E., Huber‑Lang M. Glomerular injury after trauma, burn, and sepsis. Journal of Nephrology. 2023 Aug 5. doi: 10.1007/s40620-023-01718-5.
  40. Ko A., Song J., Golovko G., El Ayadi A. et al. Higher risk of acute kidney injury and death with rhabdomyolysis in severely burned patients. Surgery. 2022. 171(5). 1412-1416. doi: 10.1016/j.surg.2021.09.029.
  41. Kellum J.A., Lameire N. KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit. Care. 2013. 17(1). 204. doi: 10.1186/cc11454.
  42. Bhetariya B.V., Desai N.J., Gupta B.D., Patel P.N. Profile of Kidney Histopathology in Cases of Burns — Particular Emphasis on Acridine Orange Fluorescence Study and to Explore its Forensic Utility. J. Clin. Diagn. Res. 2016. 10(4). EC01-5. doi: 10.7860/JCDR/2016/16302.7517.
  43. Martín-Fernández M., Heredia-Rodríguez M., González-Jiménez I. et al. Hyperoxemia in postsurgical sepsis/septic shock patients is associated with reduced mortality. Crit. Care. 2022. 26. 4. doi: 10.1186/s13054-021-03875-0.
  44. Stads S., Kant K.M., de Jong M.F.C. et al. Predictors of short-term successful discontinuation of continuous renal replacement therapy: results from a prospective multicentre study. BMC Nephrol. 2019. 20(1). 129. doi: 10.1186/s12882-019-1327-9.
  45. Mosier M.J., Pham T.N., Klein M.B. et al. Early acute kidney injury predicts progressive renal dysfunction and higher mortality in severely burned adults. J. Burn Care Res. 2010. 31(1). 83-92. doi: 10.1097/BCR.0b013e3181cb8c87.
  46. Krishtal M.V., Gozhenko M.V., Sirman V.M. Pathophysiology of kidneys: handbook. Odesa: Phoenix; 2020. 144 p. (in Ukrainian).
  47. Protsenko O.S., Shapoval O.V., Teslenko G.O. et al. Clinical and experimental studies of tissues in thermal injuries. Actual Problems of Modern Medicine. 2019. 3. 4-13. doi: 10.26565/2617-409X-2019-3-01 (in Ukrainian).
  48. Nikolenko D.Ye., Babenko V.I., Fylenko B.M. et al. Structural and functional changes of rat kidney damage in the experimental burn disease. Bulletin of Problems Biology and Medicine. 2022. 2.2(165). 175-183. doi: 10.29254/2077-4214-2022-2-2-165-175-183.
  49. Basarab Ya.O. NO-ergic system in renal tissue during burn disease. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2019. 19(2). 107-109. doi: 10.31718/2077-1096.19.2.107 (in Ukrainian).
  50. Flores Cabeza E., Sanchez-Sanchez M., Cachafeiro FuciñosL., García de Lorenzo A. Early acute kidney injury in severe burns. Burns. 2020. 46(6). 1472-1473. doi: 10.1016/j.burns.2020.01.014.

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