J.Jpn. Surg. Soc.. 91(9): 1174-1177, 1990

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Report on the annual meeting

PATHOPHYSIOLOGICAL RESPONSES IN THE KIDNEY FOLIWING SURGICAL STRESS AND INJURY

The study was undertaken to investigate patohphysiological responses in the kidney following resection of esophageal cancer. We evaluated the urineary excreted fraction of filtered low molecular proteins (F_ELMP). The F_ENa did not change after surgery and values of creatinine clearance and free water clearance significantly improved then. But the F_ELMP showed remarkable elevation following operation, especially the F_Eβ₂ microglobulin (β₂MG) reached to 95 times higher on the 1st postoperative day (POD) than before surgery. This result suggests that the amount of produced β₂MG would increase following stimulation of cytokines and elevated polymorphonuclear leukocyte elastase, and β₂MG could be called as one of acute phase reactants.
Levels of humon atrial natriuretie polypeptine (hANP) and cathecholamines were significantly elevated after surgery, and showed their highest values on 1st POD. The levels of hANP were correlated with epinephrine and norepinephrine. We insist that secretion of hANP after surgery might have a relation to the sympathetic nervousadrenal system. And We supposed hANP would administer to the homeostasis as excretion system of water and sodium against plasma renin activity and ADH in the conditions of postoperative stress. Under these considerations, it indicates β₂MG and hANP are important substances of pathophysiological responses in the kidney following surgical stress and injury.

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