Kovalov V. Pathogenetic peculiarities of kidney damage in the early period of skeletal trauma of varying severity, complicated by blood loss

In the dissertation, for the first time, a comparative analysis of prooxidant-antioxidant, functional and morphological disorders of kidneys, endotoxicosis and cytokinogenesis levels on the 1 to 7 days after modelling of skeletal trauma of different severity and additional blood loss has been conducted. It has been shown that trauma is accompanied by an increase in lipoperoxidation processes, a compensatory increase in superoxide dismutase activity and a decrease in the activity of catalase in the cortical and cerebrovascular layers of kidney and an increase in the content of fractions of medium mass molecules in blood serum. For the first time, it has been established that in the conditions of simulated injuries, diuresis and velocity of glomerular filtration, proximal and distal transport of sodium ions decreases significantly, the content of potassium ions in serum increases, excretion of sodium ions, potassium and protein increases, and relative reabsorption of water decreases. The complication of isolated skeletal trauma by blood loss and intra-abdominal hematoma deepens the detected violations throughout the entire experiment. An additional increase in the severity of skeletal trauma due to the fracture of the adjacent thigh leads to large violations, which become statistically significant after 7 days of post-traumatic period. It has been proved that along with the simulated injuries there are morphological disorders of renal tissues that are accompanied by the development of severe degenerative and necrotic changes in the epithelial cells of the excretory tubules and dominate after 7 days of the post-traumatic period after the fracture of both thighs, concomitant blood loss and hematomas of the abdominal cavity.