[Nephroprotective value of N-acetylcysteine for patients with concomitant trauma, as well as other aspects of the use of this drug in clinical practice].

An analysis and review of domestic and foreign literature on the role of N-acetylcysteine in the correction of oxidative stress, as well as the problem of oxidative stress, and protection against free radicals are presented in the article. The important role of N-acetylcysteine in replenishing the intracellular glutathione level, which is the main cell antioxidant, has been shown, as well as the potential use of N-acetylcysteine for various pathological conditions and diseases. The relevance of concomitant injury and renal dysfunction, and the experience of the clinical use of N-acetylcysteine as a nephroprotector in patients with concomitant injury in the clinic of the Department of Faculty and Endoscopic Surgery of KBSU named after Kh.M. Berbekov are also described. After reviewing the literature, based on the results of many experimental studies, we can conclude that this pharmacological substance is a very promising for replenishing the intracellular glutathione pool, and it becomes possible to include it in the combined therapy of a number of human diseases.

[Review of biomarkers for early diagnosis of acute kidney injury in patients with concomitant trauma].

Modern methods for the early diagnosis of acute kidney injury using high-precision biomarkers in various pathological conditions, including patients with combined trauma, is reviewed in the article. The pathological processes of cell damage underlying the etiology and pathogenesis of acute kidney injury require a quick and early start of preventive measures. As a consequence, the problem of early diagnosis of acute kidney damage and search of ways to optimize it are still relevant. In case of a possible acute kidney injury, in addition to situations when the renal tissue is already damaged, it is very important to determine level of acute kidney injury biomarkers in biological fluids. The results of our clinical study carried out in the clinic of the Department of Faculty and Endoscopic surgery of the KBSU named after H.M. Berbekov, dedicated to the early diagnosis of acute kidney injury in patients with combined trauma using the serum biomarker cystatin , are also presented.

[Investigation of serum cysteine concentration to monitor glomerular filtration rate for early diagnosis of acute kidney injury in patients with combined trauma].

AIM: / To determine the early diagnostic criteria for acute kidney injury in patients with combined trauma using serum cystatin C as a biomarker in the diagnostic work-up of the affected patients. MATERIALS AND METHODS: / The study comprised 42 patients who suffered combined trauma from 2015 to 2016. Cystatin C level was measured in serum. Blood sampling was done on the 1st, 3rd, 7th, 14th day of the injury. The patients were predominantly men (80%). Renal function was tested by measuring the rate of filtration and reabsorption using the Reberg-Tareev test. All patients were tested for the following parameters: serum and urine creatinine, 1-minute, 1-hour and 24-hour urine output, the rate of glomerular filtration and tubular reabsorption. RESULTS AND DISCUSSION: / Forty (95.3%) patients had normal Reberg-Tareev test values. In 2 (4.7%) patients Reberg-Tareev test results were below normal values, which was associated with the development of acute renal failure on the sixth or seventh day after trauma. The overwhelming majority of patients with combined trauma had a normal serum creatinine level (n=38). In 33 (78.6%) patients serum cystatin C level was more than 30 percent above normal values. Moreover, an increase in the cystatin C level was observed in the first 3 days, with a gradual decrease thereafter. The glomerular filtration rate, according to the Reberg-Tareev test was reduced only in 4 patients, but when the Hawk formula was used to calculate GFR, it was reduced in 33 patients. On the 3rd day after trauma, based on the increase in the serum cystatin level, 12 patients were found to have subclinical acute renal damage. At the same time, this group of patients had normal azotemia parameters. These findings suggest that measuring glomerular filtration rate using serum cystatin C has a greater accuracy in detecting latent renal dysfunction.