[The treatment of infectious-inflammatory urologic diseases and their complications by efferent detoxication methods]

This is an account of experience with extracorporeal detoxication techniques in 238 patients with urologic conditions who underwent 305 hemosorption (HS), 30 plasma sorption (PS) and 171 plasmapheresis (PA) sessions. Clinical and laboratory criteria are presented for employing an extracorporeal detoxication technique depending on predominance of suppurative septic or azotemic intoxication, and contraindications for HS, PS and PA. Absolute indications for these techniques were suppurative septic intoxication secondary to acute and chronic urologic inflammatory diseases, including septic shock, and acute renal failure. An emphasis is placed on the need for utilization of this therapy after urine flow recovery and drainage of all suppurative foci. An overview of mechanisms of different extracorporeal detoxication techniques showed them to share detoxifying and immunostimulating effects and improvement of blood rheology, renal and hepatic function. Application of the extracorporeal techniques reversed 84.4% of acute pyelonephritis, 61% of acute renal failure (without resorting to hemodialysis) and 65.4% of septic shock. This therapy was less efficient in patients with multiple organ failure. Good efficacy of xenogenic-spleen or splenocyte-suspension hemoperfusion was shown in patients with urosepsis.