EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Doppler sonography of renal parenchyma seems a rather promising diagnostic technique because kidney due to its functional and anatomic properties is a perfect model for the examination in studying systemic diseases, in particular of patients with hemoblastosis, as well as for the dynamic monitoring of the treatment process.

The purpose of this research is to study the blood flow in the renal parenchyma in patients with non-Hodgkin malignant lymphomas at various stages of the pathogenesis and the effect of the treatment on the progress of the disease.

Two groups (totaling 61 patients aged from 31 to 60) of patients suffering from non-Hodgkin malignant lymphomas (NHML) before and after polychemotherapy (PCT) and achieving of clinical hematological remission (CHR): 1^st group - 40 patients with NHML with low-grade malignancy (LGM) and the 2nd group - 21 patient’s with NHML with high-grade malignancy (HGM) of the disease. Each of the studied groups was subdivided into two subgroups, i.e., A - I-II stages of the disease, B -III-IV stages of the disease. The control group was represented by 33 healthy people.

Doppler examination of intrarenal blood flow in lobar arteries was performed on “LOGIC 400” (USA) yielding: maximum systolic velocity of the blood flow - V_max (cm/s), enddiasystolic velocity of the blood flow _min (cm/s) and the resistance index RI (Pourcelot). The computer processing of the material was based on the application software Statistica 8.0” for Windows.

On analyzing the initial changes in the renal parenchymal blood flow we found that the degree of misperfusion (decrease in V_max and rise in RI) depends not only on the stage of the disease, but also on the degree of lymphoma malignancy while the influence of the stage of the disease is more significant than the degree of lymphoma malignancy and attains its maximum for the patients of the subgroup 2B. After PCT and attaining CHR in patients I-II of the disease stages (subgroups 1 A and 2 A) the studied indices do not differ from the control parameters. The patients with lymphomas of the III-IV stages (subgroups 2 A and 2 B) after PCT and attaining CHR there is no normalization of parenchymal blood flow, although there is its positive improvement observed (increase in V_max and drop in RI).

Patients with NHML there is initial misperfusion of parenchymal blood flow in kidneys. The degree of the blood flow establishment after the treatment completion is more manifested in patients with the initial stages of the progress of non-Hodgkin malignant lymphomas and with low-grade malignancy.

The method of Doppler sonography is of great clinical significance because the state of parenchymal blood flow in the kidney indirectly characterizes the state of the blood flow in malpighian tufts and, consequently, the filtration function of the kidneys. The application of ultrasonic investigation with Doppler examination of renal arteries is of great clinical significance because it is highly informative, accessible, noninvasive and harmless for patients.