Русский
Nephroprotective effect of calcium channel blocker lercanidipine in treatment of patients with urolithiasis and urinary tract obstruction and monitoring of the serum cytokine profile
DOI: https://dx.doi.org/10.18565/urology.2019.5.48-52
A.I. Khotko, D.N. Khotko, N.B. Zakharova, A.I. Tarasenko, V.M. Popkov, A.V. Alekseev
1) Saratov State Medical University named after V.I. Razumovsky of Ministry of Health of Russia, Saratov, Russia; 2) I.M. Sechenov First Moscow State Medical University of Ministry of Health of Russia, Russia; 3) GBUZ «Republican clinical hospital named after G. G. Kuvatov», Ufa, Russia
Objective: to evaluate the nephroprotective effect of lercanidipine, its effect on the dynamics of creatinine clearance and blood cytokine levels in patients with nephrolithiasis with obstructive uropathy during renal drainage.
Material and methods. 66 patients were included in the study with concretions of the pelvic segment and the presence of obstruction according to instrumental methods of examination. In order to prevent the occurrence of infectious complications before lithotripsy patients the first stage was performed installation of nephrostomic drainage, followed by antibacterial, anti-inflammatory therapy. Patients were divided into 2 groups: the first (33 patients) received standard therapy, the second (33 people) additionally received lercanidipine at a dose of 10 mg per day for 1 month. Determined the concentration of IL-8, VEGF, MCP-1, G-CSF and GM-CSF in the blood serum by the method of solid-phase ELISA. The glomerular filtration rate was calculated using the CKD-EPI formula.
All studies were performed at the preoperative stage, on 7, 14, 21 and 28 days after renal drainage. Results. In the appointment of lercanidipine, there was a more rapid decrease in levels of IL-8, VEGF, MSР-1, GM-CSF in serum (21 days), and an improvement in renal function, compared with the group that did not receive nephroprotective therapy.
Conclusion. The administration of lercanidipine may contribute to a more rapid recovery of renal function and normalization of blood cytokine levels. This drug can be used in the complex treatment of patients with nephrolithiasis with obstructive uropathy.
Material and methods. 66 patients were included in the study with concretions of the pelvic segment and the presence of obstruction according to instrumental methods of examination. In order to prevent the occurrence of infectious complications before lithotripsy patients the first stage was performed installation of nephrostomic drainage, followed by antibacterial, anti-inflammatory therapy. Patients were divided into 2 groups: the first (33 patients) received standard therapy, the second (33 people) additionally received lercanidipine at a dose of 10 mg per day for 1 month. Determined the concentration of IL-8, VEGF, MCP-1, G-CSF and GM-CSF in the blood serum by the method of solid-phase ELISA. The glomerular filtration rate was calculated using the CKD-EPI formula.
All studies were performed at the preoperative stage, on 7, 14, 21 and 28 days after renal drainage. Results. In the appointment of lercanidipine, there was a more rapid decrease in levels of IL-8, VEGF, MSР-1, GM-CSF in serum (21 days), and an improvement in renal function, compared with the group that did not receive nephroprotective therapy.
Conclusion. The administration of lercanidipine may contribute to a more rapid recovery of renal function and normalization of blood cytokine levels. This drug can be used in the complex treatment of patients with nephrolithiasis with obstructive uropathy.
About the Autors
Corresponding author: A.I. Khotko – assistant at the Department of Urology of Saratov State Medical University named after V.I. Razumovsky; e-mail: pivovarova-nastya@ya.ru
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