Postoperative stress-induced disorders of adaptive reactivity in urological practice

Shormanov I.S., Kosenko M.V., Vorchalov V.V.

The study showed that nephrectomy is an important etiological factor of postoperative maladaptive acute stress, which is based on a significant imbalance of biogenic amines (hyperadrenalism, hypergastrinemia, the deficit of serotonin), which naturally is accompanied by severe psycho-emotional and vegetativevascular disorders, having the tendency to self-eliminate to 14 days after nephrectomy. In these adverse conditions to a greater extent trustworthy and disrupts the filtration capacity of the kidney only, assessed by estimated glomerular filtration rate (GFR) is reduced and normalized independently for all 14 days of early postoperative period. Identified significant correlation between the plasma level of adrenaline and anxiety, between the total score of anxiety and a calculated value of vegetative Kerdo index and the last index and an average estimated GFR of a single kidney. Thus, violations of system adaptation reactivity induced by nephrectomy, have a reliable negative impact on GFR of a single kidney, which can be considered as the most informative and critical indicator of the adequacy of the adaptive reactivity and functional alterations in the kidney only in terms of postoperative maladaptive stress. It is concluded that to improve outcomes nephrectomy and early prevention of disorders of the kidney remaining only later to consider the relationship of planning to adequately maintain the early postoperative period.

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nephrectomy, early postoperative period, adaptive reactivity, disadaptation stress, glomerular filtration rate