DIAGNOSTIC VALUE OF MATRIX METALLOPROTEINASE-9IN ACUTE RENAL INJURY AND PROGNOSIS OF CHRONIC KIDNEY DISEASE AFTER SURGICAL TREATMENT OF BLADDER CANCER

Acute kidney injury (AKI) is one of the most frequent and complex categories of complications after radical cystectomy (RCE), ranging from 4.7 to 38.2%. Matrix metalloproteinase-9 (MMP-9) is one of the promising markers for the early diagnosis of AKI.Material and methods. The study included 186 patients with muscle-invasive bladder cancer (RMP) T2a-3aNoMo after RCE. Urine samples for measuring the concentration of MMP-9 were obtained in the postoperative period after 6, 12 and 24 hours, as well as 3, 7 and 30 days.Results. In the early postoperative period, there were slight changes in the concentration of MMP-9, and no significant differences were found between the groups with and without AKI. 3 days after cystectomy, there is an increase in the concentration of MMP-9 in the urine in the group with AKI by 4.5 times, the high level of the marker remains on the 7th and 30th days of observation, in the group without AKI, there are no changes in the indicator at the specified time. The area under the ROC curve for urinary MMP-9 after 3 days when predicting the development of chronic kidney disease (CKD) 6 months after cystectomy was 0.848 (threshold value of 146.31 ng/ml, sensitivity of 84.1% and specificity of 73.7%), after 7 days - 0.845 (threshold value of 113.70 ng/ml, sensitivity of 83.5% and specificity of 68.2%), after 30 days - 0.745 (threshold value of 96.17 ng/ml, sensitivity of 78.3% and specificity 62.4%).Conclusion. To predict the development of CKD in patients with oncourological profile after radical surgical treatment, in addition to the generally accepted diagnostic tools, it is recommended to use the marker of renal damage and extracellular matrix remodeling (ECM) - MMP-9.

acute kidney injury, postoperative complications, matrix metalloproteinase-9, chronic kidney disease, radical cystectomy

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