Role of acute phase proteins in diagnosis of uremic pancreatitis and destructive pancreatitis in patients receiving renal replacement therapy (programmed hemodialysis)

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Abstract

Objective. To determine the blood serum β2-microglobulin and α2-macroglobulin concentration in patients undergoing renal replacement therapy (programmed hemodialysis) for the diagnosis of uremic pancreatitis and / or destructive pancreatitis.

Materials and methods. The study involved 52 patients admitted to the Surgical Unit of Astrakhan "RZhD-Medicine" Hospital and City Clinical Hospital № 3. The blood serum β2-microglobulin and α2-macroglobulin concentration was analyzed in patients admitted on an emergency basis with suspicion of uremic pancreatitis and destructive pancreatitis, who receive renal replacement therapy (programmed hemodialysis). The control group included 50 outpatients undergoing renal replacement therapy (programmed hemodialysis). The study did not include patients with suspected pancreatitis who were not receiving renal replacement therapy. The period of the study is 2019–2021.

Results. The concentration of blood serum β2-microglobulin is statistically higher than normal in all patients, who had received renal replacement therapy (programmed hemodialysis) in anamnesis. The most statistically high concentration of β2-microglobulin was revealed while studying patients with uremic pancreatitis (n = 34), and was (30.0 ± 2.75 mg/l) compared with the blood serum concentration in patients with destructive pancreatitis (8 ± 0.51 mg / l). The concentration of α2-macroglobulin was statistically lower in destructive pancreatitis (n = 18) and was 615 ± 161 mg/l compared with uremic pancreatitis (980 ± 216 mg/l). In the control group of outpatients (n = 50) receiving renal replacement therapy (programmed hemodialysis), no statistically significant blood serum concentrations of β2-microglobulin and α2-macroglobulin were found.

Conclusions. A clear dependence of the concentration of β2-microglobulin and α2-macroglobulin on the severity of uremic pancreatitis and destructive pancreatitis was established. Statistically high values of β2-microglobulin concentrations were obtained in patients with uremic pancreatitis, and the α2-macroglobulin level was statistically low in destructive pancreatitis.

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The purpose of the study. Determination of β2-microglobulin and lactoferrin concentration in blood serum in patients on  renal replacement therapy (programmed hemodialysis) for the diagnosis of uremic pseudoperitonitis and peritonitis.

Materials and methods. We examined 56 patients admitted to the surgical department of the hospital RZD-Medicine and the City Clinical Hospital no. 3 in Astrakhan, and the concentration of β2-microglobulin and lactoferrin in the blood serum of patients admitted on an emergency basis with suspicion of uremic pseudoperitonitis or peritonitis, who receive renal replacement therapy (programmed hemodialysis). The control group included 50 outpatients on renal replacement therapy (programmed hemodialysis). The study did not include patients with suspected peritonitis who did not receive renal replacement therapy (programmed hemodialysis). The period of the study is 2019-2021.

Results. The concentration of serum β2-microglobulin is statistically higher than normal in all patients receiving renal replacement therapy (programmed hemodialysis) in history. The most statistically high concentration of β2-microglobulin was detected in a study in patients with uremic pseudoperitonitis (n = 39), and was (30,000 ± 6680 ng / ml), compared with the concentration in serum in patients with peritonitis (6000 ± 519.9 ng / ml). The concentration of lactoferrin is statistically high in peritonitis (n = 17) and was (3480 ± 439 ng / ml), compared with uremic pseudoperitonitis (1160 ± 148 ng / ml). In the control group of outpatients (n = 50) receiving renal replacement therapy (programmed hemodialysis), statistically significant serum concentrations of β2-microglobulin and lactoferrin were not detected.

Conclusions. A clear dependence of the concentration of β2-microglobulin and lactoferrin on the severity of uremic pseudoperitonitis and peritonitis was established. Statistically high values ​​of β2-microglobulin concentration were obtained in patients with uremic pseudoperitonitis, and the level of lactoferrin was statistically high in peritonitis.

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About the authors

Kazim G. Gasanov

Astrakhan State Medical University

Author for correspondence.
Email: nazim.gasanov.1985@mail.ru

postgraduate student, Department of Surgical Diseases of Pediatric Faculty

Russian Federation, Astrakhan

Viktor A. Zurnadzhyants

Astrakhan State Medical University

Email: zurviktor@yandex.ru

MD, PhD, Professor, Head of Department of Surgical Diseases of Pediatric Faculty

Russian Federation, Astrakhan

Eldar A. Kchibekov

Astrakhan State Medical University

Email: Eidar_76@inbox.ru

MD, PhD, Professor, Department of Surgical Diseases of Pediatric Faculty

Russian Federation, Astrakhan

M. I. Shikhragimov

Astrakhan State Medical University

Email: nazim.gasanov.1985@mail.ru

Assistant, Department of Surgical Diseases of Pediatric Faculty

Russian Federation, Astrakhan

References

  1. Zemchenkov A.Yu., Tomilina N.A. "K / DOQI" refers to the origins of chronic renal failure (on the new K / DOQI section on the diagnosis, classification and assessment of the severity of chronic kidney disease. Nefrologiya I dializ 2004; 3: 204–220 (in Russian).
  2. Smirnov A.V., Shilov E.M., Dobronravov V.A. National recommendations. Chronic kidney disease: basic principles of screening, diagnosis, prevention and treatment approaches. Nephrology 2012; 16 (1): 1–4.
  3. Smirnov A.V., Dobronravov V.A., Kayukov I.G., Yesayan A.M. Chronic kidney disease: Further development of the concept and classification. Nephrology 2007; 11 (4): 7–15 (in Russian).
  4. Tomilina N.A., Andrusev A.M., Peregudova N.G., Shinkarev M.B. Replacement therapy of endstage chronic renal failure in the Russian Federation in 2010–2015. Report on the data of the All-Russian Register of Renal Replacement Therapy of the Russian Dialysis Society. Nephrology and dialysis 2017; 19 (4): 1–95 (in Russian).
  5. Webster A.C., Nagler E.V., Morton R.L., Masson P. Chronic Kidney Disease. National Library of Medicine 2017; 389: 1238–1252.
  6. Abramova E.E., Koroleva I.E., Tov N.L., Movchan E.A., Naborshchikov D.A. Death risk factors in patients on hemodialysis. Journal of Siberian Medical Sciences 2015; 6: 15 (in Russian).
  7. Bikbov B.T., Tomilina N.A. Substitution therapy of patients with chronic renal failure in the Russian Federation in 1998–2011. Nephrology and dialysis. 2014; 16 (1): 13–29 (in Russian).
  8. Ryabov S.I. Treatment of chronic renal failure. Saint Petersburg: Saint Petersburg State Medical University named after I. I. I. P. Pavlova 1997; 96–97 (in Russian).
  9. Mitkov V.V., Bryukhovetskiy Yu.A. Clinical guidelines for ultrasound diagnostics. Moscow: VITAR 1996; 140–187 (in Russian).
  10. Saveliev V.S., Filimonov M.I., Burnevich S.Z. Acute pancreatitis. Clinical Surgery. National leadership 2009; 2: 196–229 (in Russian).
  11. Gelfand B.R., Zabolotskikh I.B. Intensive therapy. National leadership. Moscow: GEOTAR – Media 2017; 928 (in Russian).
  12. Working Group IAP/APA Acute Pancreatitis Guidelines.IAP/APA evidence-based guidelines for the management ofacute pancreatitis. Pancreatology 2013; 13: 1–15, available at: https://doi.org/10.1016/j.pan.2013.07.063.
  13. Loganikhina K.Yu., Gordinko K.P., Kozarenko T.M. The role of multi-detector computer tomography in diagnostics of acute pancreatitis. Clinical surgery 2014; 10: 13–15.
  14. Lutseva O.A., Zurnadzhiants V.A., Kchibekov E.A., Musagaliev A.A., Kokhanov A.V. Possibilities of serum indicator enzymes in the differential diagnosis of atypical forms of acute appendicitis. Bulletin of Surgical Gastroenterology 2018; 5: 611–612 (in Russian).
  15. Thoeni R.F. The revised Atlanta classification of acutepancreatitis: its importance for the radiologist and its effecton treatment. Radiology 2012; 262 (3): 751–764, available at: https://doi.org/10.1148/radiol.11110947.
  16. Ilyukevich G.V., Smirnova L.A. Ferroproteins as markers of systemic inflammatory response in acute widespread peritonitis. Vesti NAS of Belarus. Gray honeybial. navuk 2002; 2: 23–25 (in Russian).
  17. Nazarenko G.I., Kishkun A.A. Clinical assessment of the results of laboratory studies. Moscow: Medicine 2000; 346–388 (in Russian).
  18. Severina E.S. Biochemistry. Moscow: GEOTAR – Media 2003; 779 (in Russian).
  19. Deegens J., Wetzels J. Fractional excretion of high- and low-molecular weight proteins and outcome in primary focal segmental glomerulosclerosis. Clin Nephrol 2007; 68 (4): 201–208.
  20. Matsuo N. Clinical impact of a combined therapy of peritoneal dialysis and hemodialysis. Clin Nephrol 2010; 74 (3). 209–213.
  21. Kolina I.B., Stavrovskaya E.V., Shilov E.M. Dyslipidemia and chronic progressive kidney disease. Terapevticheskij arhiv 2004; 76 (9): 75–78 (in Russian).
  22. Polyakov D.S., Shavlovsky M.M. Molecular bases of β2-microglobular amyloidosis. Medical academic journal 2014; 14 (1): 24–41 (in Russian).

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Copyright (c) 2021 Gasanov K.G., Zurnadzhyants V.A., Kchibekov E.A., Shikhragimov M.I.

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