INDICATORS OF RENAL BLOOD FLOW IN INFRAVESICAL OBSTRUCTION

Summary. Obstructive diseases of the urinary tract unite a complex of pathomorphological and pathophysiological changes that occur in the kidney and urinary tract, resulting from impaired urodynamics and leading to impaired renal function. One of the common variants of obstructive urinary tract diseases is infravesical obstruction (IVO). The aim of the study was to study the parameters of renal blood flow in infravesical obstruction. In order to determine violations of intrarenal hemodynamics in acute infravesical obstruction, we conducted a urological examination of 112 patients aged 51 to 86 years and older who were hospitalized in the urological departments of the National Hospital under the Ministry of Health of the Kyrgyz Republic with infravesical obstruction due to benign prostatic hyperplasia. The average age of patients was 73.2±2.4 years Urological examination included ultrasound examination (ultrasound) of the kidneys, bladder and prostate with determination of the amount of residual urine, as well as the study of renal blood flow - ultrasound duplex scanning with color Doppler blood flow mapping (UDS with CDCC). The results of the study showed that acute IVO with the development of hydronephrotic transformation in the kidney leads to violations of renal hemodynamics, manifested by changes in the quantitative parameters of organ blood flow - an increase in resistivity (renal glomerular arterioles) and systolic diastolic ratio, as well as a decrease in end-diastolic velocity, which leads to renal hypoperfusion. Renal blood flow disorders eventually lead to ischemia of its parenchyma, which, in combination with acute urinary retention, are predisposing factors to the development of secondary acute inflammation of the kidneys. This circumstance must be taken into account in the treatment of patients with acute IVO in combination with hydronephrotic transformation, which implies adequate drainage of the lower urinary tract, the appointment of appropriate antibiotic therapy and drugs that improve microcirculation.