Distributia tratamentului anti-HTA preoperator si a variabilelor perioperatorii la pacientii care au dezvoltat IRA postoperatorie dupa nefrectomie pentru tumora renala

Objectives. The purpose of this article is to analyze the distribution of preoperative antihypertensive treatment and perioperative variables in patients who developed postoperative acute renal injury after transperitoneal radical nephrectomy for parenchymal renal tumor. Material and method. We conducted a prospective study of patients admitted and treated in the "Fundeni" Clinic of Urology and Renal Transplant, diagnosed with renal parenchymal tumor and undergo transperitoneal radical nephrectomy between 2007-2010. The study included a total of 183 patients divided into two groups depending on the development of postoperative AKI: group 1-115 patients who developed postoperative AKI and group Il - 68 patients without postoperative AKI. All data were interpreted using SAS software 9.1 (SAS Institute, Can/, NC) and Limdep (Econometric Software Inc.. Plainview, Ny). Results. Most patients were between 61-70 years (30.9%), followed by those between 51-60 years (29.4%) , M/F= 9:8. In terms of antihypertensive treatment in the two groups the proportion of patients treated with ACE inhibitors for hypertension is 53.04% and 51.47% in the AKI group versus the control group. Beta-blockers (metoprolol and atenolol) were in second place after ACEI, in the treatment of hypertension, 23.47% in the AKI group and 14.7% in the control group. Treatment of hypertension with Ca2+channel blockers was used at a rate of 1 5.65% and 11.76% in the AKI group vs. the control group and, by active substance, felodipine 8.09% in the AKI group and 2.93% in control group; amlodipine 4.34% in the AKI group and 2.94% in the control group; diltiazem - 2.60% in the AKI group and 2.94% the control group. Conclusions. Captopril and Enalapril are most frequent ACEI drugs used and with an almost equal istribution in both study groups. Beta-blockers (Metoprolol and Atenolol) were in second place after ACEI, in the treatment of hypertension. Perioperative bleeding is the only factor involved the occurrence of postoperative AKI, but our study showed no statistical significance. Key words; renal cell cancer, acute kidney injury, angiotensin converting enzyme inhibitors, antihypertension treatment.

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