Maksymchuk N. Adjunctive-base nephroprotection and monitoring for endogenous intoxication syndrome in intensive therapy of purulent-septic complications

The study includes the results of examination and treatment of 117 patients with acute kidney damage in endogenous intoxication syndrome of purulent-septic origin. A comparative characteristic of the dynamics of indicators that characterize the functional state of the kidneys, endogenous intoxication syndrome and parameters of the cardiovascular system is carried out. The proposed use of sorbylact and L-arginine against the background of standard therapy allows restoring the indicators of excreted sodium and potassium fractions to the control level, reducing the reabsorption of medium - weight molecules, and activating the volumetric and osmoregulatory functions of the kidneys. Among the studied markers of acute kidney damage, neutrophil gelatinase-associated lipocalin has the highest operational characteristics (AUC=0.92) and allows verifying the presence of damage to the nephron tubules with a sensitivity of 79% and a specificity of 92 %. Practical recommendations for the diagnosis and treatment of acute kidney damage were developed and implemented, which made it possible to reduce the transition to chronic kidney disease by 1.7 times.