INFLUENCE OF LASER TREATMENT ON INDICATORS OF FREE-RADICAL OXIDATION AND ANTIOXIDANT PROTECTION IN SECONDARY PYELONEPHRITIS

Relevance. Optimization of the conservative tactics of acute inflammation of the kidney in nephrolithiasis makes it advisable to use non-traditional methods of detoxification low-intensity laser radiation (LILR) in particular. Aim. To evaluate the effectiveness of laser therapy (LT) in the complex correction of acute secondary pyelonephritis (ASP) in patients with single kidney stones according to the basic adaptation criteria of oxidative-antioxidant clinical medicine КЛИНИЧЕСКАЯ МЕДИЦИНА homeostasis of the organism. Materials and methods. Indices of endogenous intoxication (EI), characterizing the oxidative-antioxidant homeostasis of the body in ASP, were studied in 96 patients with nephrolithiasis aged 19 to 40 years. Patients of the comparison group (48 people) underwent basic (according to the standards) treatment aimed at controlling of calculous pyelonephritis. Patients of the main group (48 people) in the traditional conservative therapy from the second day of hospitalization daily received additional LT sessions with apparatus LTA “Uzor-3KS” with a frequency of 0.6 kHz, a power of 1.5 watts within 4 minutes (total for treatment course is eight procedures). The effectiveness of therapy was assessed on the 5th and 9th day of the inpatient stay. Results. It was found that endotoxicosis in non-destructive forms of ASP is caused by the increase in the concentration of malonic dialdehyde of plasma (by 20.3%) and erythrocytes (by 35.5%), decrease in catalase activity (by 14.2%) and the amount of total (by 11.8%) and free (21.1%) thiol groups with a decrease in the detoxification index (DI) by 24,1%. Compared with the baseline therapy (BT), the effectiveness of LT in the complex treatment of ASP in the analyzed parameters of metabolic homeostasis against the background of the increase in catalase capacity from 6.9 to 10.2%, the detoxification index from 5 to 12.5% was 7.5% (on the 5th day) and 17.5% (on the 9th day of treatment). Conclusions. ASP leads to activation of ROS, suppression of antioxidant and catalase activity of blood, reduction of DI, indicating a subcompensated syndrome of EI. Standard therapy contributes to the normalization of ROS and SLA values of body protection and reduces the level of endotoxicosis caused by ASP. Additional inclusion in the complex treatment of LT sessions more significantly normalizes redox metabolic homeostasis and EI parameters, improving the effectiveness of basic therapy.

nephrolithiasis, secondary pyelonephritis, lipid peroxidation, antioxidant system, laser therapy