Kolesnikova T. Assessment of functional status of renal tubular apparatus for osmotic homeostasis change in acute renal failure of various ethiology.

Object: functional condition of renal tubular apparatus in patients with osmotic homeostasis disorders by datas of water-salt and nitrogenous exchange. Purpose: to find out informativeness of osmotic homeostasis' indexes for the estimation the degree of renal tubular apparatus disorders and to develop the laboratory diagnostics criteria for prediction of acute renal failure outcomes. Research methods: biochemical, clinical, hormonal and statistical. Novelty: it is shown the significant role of osmotic homeostasis datas to differentiate the renal and nonrenal disorders of kidney's functions; the necessity of free water clearence determination to evaluate the functional condition of renal tubular apparatus in transplantology; It is proved that in patients with acute cerebral insufficiency there is not the decompensation of central and peripheral mechanisms of sodium and osmotic homeostasis support; hypernatriemia in severely ill neurosurgical patients is confirmed to be a compensative saving mechanism for electro-neutrality blood plasma due to increasing of remaining anions concentration. Results: free water clearence is the early diagnostics criterion of acute renal failure in patients with various degree of azotemia; free water clearence is the important criterion of renal tubular apparatus recovery in patients after acute renal failure;it is found high correlation between free water clearance datas and the severity of nephropathy in pregnants; it is shown that hypernatremia is a prognostically unfavourable factor during acute renal failure development; the significant role of osmotic homeostasis determination for recipients and potential donors of kidney transplant is proved. Medical activity is implemented in the Donetsk regional clinical territorial medical association, Donetsk regional center of guard of maternity and childhood, educational-scientifically medical complex "the University clinic" DonNMU and Donetsk regional anticancer center, and in the pedagogical process of M. Gorky Donetsk National Medical University. Вranch of knowledge is medicine (physiology).