The authors analyzed different modes of prevention of
acute renal failure (ARF) in the planned surgical treatment of
abdominal aortic aneurysms. A hundred patients randomly divided into 4 groups were examined. In patients from a control group, prevention of
renal failure included no use of
aminoglycosides, prevention of
hyperglycemia, and provision of steady-state hemodynamics. In Group 2 patients, the reperfusion syndrome was prevented through a preventive load and early administration of
antioxidants, for which they were enterally fed with Berlamine-modular for 5 days before surgery and in the postoperative period. The authors made efforts for Group 3 patients to have high
oxygen supply values at all stages of surgical treatment. For this, they optimized infusion
therapy and compensated for intraoperative blood loss by preoperatively prepared autoblood and through reinfusion of the blood collected from an operation
wound with "Cell saver" apparatus. In Group 4 patients, the prevention of
ischemia and reperfusion were simultaneously made and blood
oxygen-transporting function was optimized. Renal function was evaluated from the activity of urinary
enzymes and from
nitrogen metabolic parameters. The studies have indicated that activation of
free radical lipid peroxidation in the presence of
ischemia/reperfusion and blood
oxygen-transporting dysfunction plays an important role in the genesis of
renal failure during surgical treatment for infrarenal
aortic aneurysms. According to the data on changes occurring in urinary enzymatic activities, the preventive load with
antioxidants and their early postoperative use ameliorate renal lesion. The similar effect is achieved by the provision of high tissue
oxygen supply and uptake at all the stages of surgical treatment. The best effect shown, in addition to enzymuria diminution, by a clinical reduction in the frequency of renal dysfunction is achieved by applying a comprehensive approach to preventing ARF.