Clinical consequences of nephrectomy performed on medical grounds.

UNLABELLED: Epidemiological data show that chronic kidney disease (CKD) is a serious social problem and nowadays is included amongst civilisation diseases. Knowing the relation between decrease in the number of nephrons and progressing kidney damage caused by it, we can treated each nephrectomy from medical reasons as a risk factor for development of CKD. The aim of this study was a retrospective analysis of clinical effects of nephrectomy, taking into account evaluation of a functional status of the sole kidney. PATIENTS AND METHODS: The study covered 182 patients after nephrectomy in the period from 1979 to 2008. The morphological and functional status of the remaining kidney was evaluated using ultrasound scanning and on a basis of serum levels of creatinine, as well as the glomerular filtration rate. Occurrence of proteinuria and blood pressure values were also verified. RESULTS: The average creatinine serum levels increases after nephrectomy and is positively correlated with the age. The mean eGFR level is lower after nephrectomy and is correlated with kidney dimensions in the long-term control after nephrectomy, and with the age. The average systolic and diastolic blood pressure after nephrectomy in the long-term observation was higher as compare with values before procedure. Presence of protein in the urine of patients after nephrectomy correlated positively with increased blood pressure values. CONCLUSIONS: Nephrectomy constitute the risk factor of development of CKD and hypertension. Patients after nephrectomy needs systematic nephrological care to prevent CKD progression.

[Bladder cancer biomarkers]. / Wyznaczniki procesu nowotworowego w raku pecherza moczowego.

Bladder cancer is one of the most prevalent cancers worldwide. Non-muscle invasive bladder cancer has a 70% rate of recurrence. Its biological tendency to recur and progress mandates close follow-up for the early detection of recurrent tumors. Urine cytology is the most widely used noninvasive test to detect urothelial tumors. However, it is limited by its low sensitivity. On the other hand, cystoscopy is the gold standard procedure to follow patients with a history of bladder cancer but this test is invasive and expensive. Therefore, there is a real need to develop new tests that can be used in bladder cancer surveillance. In recent years there is a constant effort to find a better non-invasive marker for bladder cancer. Many markers for the detection of bladder cancers have been tested and almost all urinary markers reported are better than cytology with regard to sensitivity, but they score lower in specificity. Our knowledge of molecular pathways in bladder cancer is growing and new methods of marker development emerge, but the perfect marker is still to be found. Currently, there are not clinically usable molecular markers that can guide us in diagnosis or surveillance, nor guide us in lowering the frequency of urethrocystoscopy in bladder cancer. This article reports some of the more prominent urine markers in use today.