Abdelrakhman M. Clinical efficacy of puncture sclerotherapy of parapelvic renal cysts complicated by arterial hypertension.

New information was received in thesis which defines pathogenetic mechanisms of arterial hypertension (AH) during simple parapelvic renal cysts. It was established that with progression of hemodynamic damages and increase of hormone production (renin, aldosterone), they are associated with the development of endothelium dysfunction that is marked by vasoconstrictors activation (ЕТ-1) in response on stress conditions of ischemic probe with compression of brachial artery (?2 = 4,62; p <0,05) and increase of influence of vasodilators (monoxide of nitrogen - NO, and cyclic guanosine monophosphate), that is caused by decrease of endothelium dependent vasodilation and predisposition to spastic vascular reactions when there is presence of pyelonephritis (?2 = 4,78; p<0,05). Hemodynamic and biochemical criteria of subclinical stage of disease were determined based on integral analysis of correlated interaction between parameters of endothelium dependent vasodilation (EDV), dynamics of humoral factors, associated with endothelium function (ЕТ-1, NO, cyclic guanosine monophosphate) during ischemic probe level of systolic arterial pressure, Doppler velocimetry indices of kidney haemodynamics and also comparison with clinical and ultrasound morphometric indices. It was established that puncture sclerotherapy of simple parapelvic renal cyst can be used in 75,0% cases; it is careful and provides high efficacy of cysts elimination and it is the most possible at cysts of size to 10 sm - ?2 = 5,85; p <0,05 (88,9% - full regression; 7,4% - small clinically inactive residual cavity to 30% of previous size; 3,7% - relapse). The use of this approach allows neutralizing main pathogenetic mechanisms of the development of clinical symptoms, which assists in normalization of systemic haemodynamics and arterial pressure (arterial hypertension) (57,6% - stabile normalization of AP; 30,3% - decrease and stabilization of AP; 12,1% - insufficient clinical efficacy).