On March 13, World kidney day is celebrated. Almost 3.5 million people in our country have nephrological diseases and urolithiasis. And the annual increase in patients with a kidney tumor is about 20 thousand people.
“If we are talking about a small tumor, today in 98% of cases we save the patient from this disease for life,” says Deputy Director for Scientific Work of the Institute of Urology and Reproductive Health of Human University, Professor Evgeny Shpot.
In what regions are higher the risk of urolithiasis? How often do you need to do an ultrasound of the kidneys? How does artificial intelligence help surgeons? The doctor told Aif.ru about this.
Stones, cancer and inflammation
Julia Board, Aif.ru: Evgeny Valerievich, how often do our kidneys suffer, which diseases are most common?
Evgeny Shpot: The kidney is associated with very many processes in the human body: and supports homeostasis (stability within the body, regardless of external influences – approx. Ed.), And regulates pressure. So, if the patient has massive bleeding or he was poisoned by the salts of heavy metals, then this vital organ suffers first.
Kidney diseases should be divided into two significant groups: nephrological and urological, including oncomorology. According to statistics, about 2.5 million people are ill with nephrological diseases in Russia. In particular, these are various options for glomerulonephrites, acute and chronic kidney disease. Among urological diseases, urolithiasis leads, it is diagnosed annually in almost more than a million patients. In oncourology, the kidney tumor ranks third after cancer of the prostate and bladder. The annual increase in patients with this disease is about 20 thousand people.
– What is the reason for such an increase in the incidence?
– First of all, we associate this with improving the quality of diagnosis. The kidney tumor is easily diagnosed with ultrasound, CT or MRI. About 20 years ago, we very often encountered late stages when people came with huge formations. It was impossible to keep the kidney, but sometimes even remove the tumor. With an increase in the quality of diagnosis, the situation has changed dramatically: we now more often remove the kidney tumor in the early stages, so there is an opportunity to preserve the organ.
– Who often has kidney diseases? Who is at risk?
– In most cases, men get sick a little more often than women. With urolithiasis, for example, the region of residence is very important. Endemically higher, the level of urolithiasis, in particular, in Siberia and in the Far East (Altai Territory, Magadan and Amur Region). This is due to nutritional characteristics and food habits of the region of the region.
Without pain and cuts
– What operations are used today?
– If we talk about urolithiasis as the most common disease, then various endoscopic interventions are used for its treatment. The first group is percutaneous endoscopic interventions, in particular, percutaneous nephrolytotripsy, when we make a small puncture and remove the stone through it. Recently, retrograde intrarenal surgery (RIRKh) has become popular, when the stone is removed without sections on the patient’s body – through the ureter. To do this, use a thin flexible urteronephroscope to crush the stone. The advantages of such an operation for patients are obvious – at least postoperative complications and the fastest recovery.
– Is artificial intelligence used to diagnose and treat kidney diseases?
-In Russia, the Sechenov.ai_nephro web platform was developed and introduced into clinical practice to plan organ-preserving operations to remove the kidney tumor. This system has no analogues in the world, it automatically combines four phases of CT research in a single three-dimensional image in just a few minutes. Based on the 3D model, the surgeon can plan in detail the course of a real operation in a patient with a renal neoplasm. The use of the web platform can significantly reduce the risk of postoperative complications and perform an operation to remove the tumor, while preserving the functioning organ. The use of the web platform in our institute made it possible to radically change the structure of such operations. If in the early 2000s the rejection of the kidney (the operation to remove the neoplasm with the preservation of the body) was no more than 20-30% of the operations, then ten years later the number of such operations increased to 80–90%.
Ultrasound – once a year
– If a kidney tumor occurs, can you live with one?
-Nature is so arranged that we have two kidneys, each of which functions only 60-70% of its capabilities. Even if a person loses one kidney as a result of an illness or surgery, then the second almost completely takes on all functions, and this, as a rule, does not affect the health of the patient.
– Can there be a defeat of both kidneys at once?
-Not often, bilateral kidney cancer is found in 2-3% of observations, this is the most difficult situation for cancer. Nevertheless, our doctors carry out simultaneous laparoscopic resection of the kidney regarding bilateral formations. In one anesthesia, we remove two tumors at once: both left and on the right, and this is done with minimally invasive access through small punctures. In this area, extensive experience has already been accumulated – more than 40 operations, and no one does it in Russia.
– Does patients need additional treatment, for example, chemotherapy after surgery for kidney resection?
– Since we, as a rule, encounter a kidney tumor in the early stages, most often there is no need for further treatment of such patients. We have very good results of oncological treatment of the kidney tumor in the early stages. If we are talking about removing a tumor up to 2 cm in size, then in 98% of observations we save the patient from this disease for life. The larger the tumor, the worse the forecast. For example, at a T3-A stage, the forecast is already in the region of 60% during five years of survival.
Therefore, the early diagnosis of the kidney tumor comes first. All patients from young age are recommended to undergo an ultrasound study of the kidneys once a year. This is a simple and reliable way that will reveal almost any disease in the early stages: urolithiasis, hydronephrosis, kidney tumor.
– Is it possible to suspect cancer on blood test?
– Unfortunately, there are no other objective criteria except creatinine and urea. There are no markers of kidney cancer today, scientists are only in the process of their search. But when the doctor is faced with an increase in creatinine and urea, this already indicates some serious impaired renal function.
Source: aif.ru