Diagnostic value of serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), IL-6, TNF-a, and IL-1b in preserving kidney function in diabetic renal cell carcinoma patients undergoing partial resection: A focus on the TGF-b1/Smad pathway.

Abstract

Background: This study aimed to evaluate the protective effects of dexmedetomidine (DEX) on renal damage in diabetic patients with renal cell carcinoma undergoing partial nephrectomy. Specifically, it focused on oxidative stress markers, inflammatory cytokines, and the TGF-b1/Smad signalling pathway.

Methods: Between August 2022 and July 2024, 100 diabetic patients with renal cell carcinoma undergoing partial nephrectomy were randomly assigned to receive either 1.0 mg/kg of DEX or normal saline (control) during surgery. Blood samples were taken preoperatively, intraoperatively, and postoperatively to measure oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], glutathione peroxidase [GSH-Px]), inflammatory cytokines (IL-6, TNF-a, IL-1b), and renal function indicators (BUN, Scr, CysC). The TGF-b1/Smad pathway and renal cell apoptosis were also assessed.

Results: No significant differences in baseline markers were observed between the groups. However, during and after surgery, the DEX group exhibited significantly lower MDA levels and higher SOD and GSH-Px levels (P<0.05), indicating reduced oxidative stress. Inflammatory markers (IL-6, TNF-a, IL-1b) were also lower in the DEX group.

Conclusions: DEX significantly mitigates renal damage in diabetic patients undergoing partial nephrectomy by reducing oxidative stress, inflammation, and apoptosis and by inhibiting the TGF-b1/Smad pathway. These findings suggest its potential as a protective agent for high-risk surgical patients.