Electrolyte and renal disorders in patients with newly diagnosed glioblastoma

Purpose: Disturbances of electrolytes and renal function have been linked to the prognosis of critically ill patients and recently also of cancer patients. This study aimed to assess electrolyte and renal disorders in glioblastoma patients and evaluate their prognostic effect. Methods: Medical records of patients with newly diagnosed glioblastoma between 2005 and 2018 were retrospectively reviewed for electrolyte and renal function parameters and for demographic, clinical and outcome parameters. Results: Electrolyte and renal function disorders were associated with poorer survival in univariate and Kaplan–Meier analysis. Multivariate analysis revealed hypochloremia as an independent prognostic factor for overall and 1-year survival. Conclusion: Only hypochloremia showed an association with glioblastoma prognosis, independent of other known prognostic factors, as age or molecular status.

Evaluation of the corrective effect of therapeutic plasmapheresis on the state of renal function in patients after surgical treatment of localized kidney cancer

Purpose of the study. To assess the state of renal function in the application of therapeutic plasmapheresis in order to correct the disorders accompanying the development of preclinical stage of AKI in patients after partial nephrectomy under conditions of warm ischemia.Patients and methods. We examined 119 patients (average aged 57.6±7.8 years) from 2018 to 2019, who underwent open or laparoscopic kidney resection for cancer according to elective indications and with the usage of standard WIT technique within 15-21 minutes. Patients with a high risk of developing a clinical stage of AKI (n=21) were divided into 2 groups: in group I (n=10), patients continued to receive standard nephroprotective therapy, in group II (n=11), 24 hours after surgery, therapeutic plasmapheresis was performed according to the TPE (Therapeutic plasma exchange) protocol. During 7 days after the surgery patients in both groups were monitored daily for the rate of hourly diuresis, serum creatinine, and creatinine GFR. The presence of significant differences in the groups was evaluated using the STATISTICA 12.6 software package and the differences between the samples were considered significant at p<0.05.Results. The development of the clinical stage of AKI in group I was detected in 80.0 % of cases, in group II in 9.0 % of patients (p=0.0019). The rate of diuresis in group II was significantly higher: by more than 2 times by day 3, by 90.0 % on day 4, by 81.4 % on day 5, by 36.8 % on day 6, and by 25.4 % on day 7 (p<0.05). The average increase in creatinine in group I was significantly higher: more than 5 times on day 5 and more than 4 times on day 6 and 7 of the study (p<0.05). GFR in group II was significantly higher on day 3 (65.3 %), day 5 (54 %), day 6 (39.2 %) and day 7 (50 %) (p<0.05).Conclusion. Therapeutic plasmapheresis is highly effective in the correction of renal function disorders after kidney resection under WIT conditions and demonstrates an advantage in reducing the risk of developing a clinical stage of AKI in comparison with preventive measures that include standard nephroprotective infusion therapy.

Monitoring Serum Creatinine, Blood Urea Nitrogen in Patients Brain Injury with Mannitol Therapy

Increased intracranial pressure is a further effect of brain injury due to structural damage and osmotic and water imbalances (Edema). Mannitol works in the proximal tubules and mannitol in the absorption of tubular cells by the mechanism of pinocytosis. The fluid transfer will draw fluid into the intracellular, so that the cell will be switched and broke. This phenomenon is referred to as the phenomenon of "Nephrosis Osmotic", in which mannitol administration may occur as a result of accumulation of drugs in the kidneys due to prolonged exposure to mannitol in the kidney and given dosage. The effects of osmotic diuresis occurring plus the dose and duration of mannitol administration are reported to cause renal function disorders (Scr and BUN). The aim of this study was to analyze changes in serum creatinine and BUN in patients with brain injury from before receiving mannitol therapy and during mannitol treatment. From the results of the study the number of patients who met the inclusion criteria, 32 patients. Serum creatinine, the initial average of 0.85 ± 0.17 mg / dl and the last day of the mean SCr 0.74 ± 0.30 mg / dl. While the mean BUN (Blood Urea Nitrogen) was 11.27 ± 2.75 mg / dl and the mean last day was 17.08 mg / dl ± 8.59 mg / dl. From Serum Creatinine and BUN data it can be concluded that there is no significant change.

Monitoring Serum Creatinine, Blood Urea Nitrogen in Patients Brain Injury with Mannitol Therapy

Increased intracranial pressure is a further effect of brain injury due to structural damage and osmotic and water imbalances (edema). Mannitol works in the proximal tubules and mannitol in the absorption of tubular cells by the mechanism of pinocytosis. The fluid transfer will draw fluid into the intracellular, so that the cell will be switched and broke. This phenomenon is referred to as the phenomenon of "Nephrosis Osmotic", in which mannitol administration may occur as a result of accumulation of drugs in the kidneys due to prolonged exposure to mannitol in the kidney and given dosage. The effects of osmotic diuresis occurring plus the dose and duration of mannitol administration are reported to cause renal function disorders (Scr and BUN). The aim of this study was to analyze changes in serum creatinine and BUN in patients with brain injury from before receiving mannitol therapy and during mannitol treatment. From the results of the study the number of patients who met the inclusion criteria, 32 patients. Serum creatinine, the initial average of 0.85±0.17 mg/dl and the last day of the mean SCr 0.74±0.30 mg/dl. While the mean BUN (Blood Urea Nitrogen) was 11.27±2.75 mg/dl and the mean last day was 17.08 mg/dl±8.59 mg/dl. From Serum Creatinine and BUN data it can be concluded that there is no significant change.