PREDICTORS OF PROGRESSION OF CHRONIC PYELONEPHRITIS IN CHILDREN

Abstract

Introduction The search for new diagnostic capabilities adverse forecasting of chronic pyelonephritis in children is a pressing issue today. To determine the degree of destruction of renal parenchyma, structural and functional changes in kidney informative study of fermenturiyi, analyze its relationship with albuminuria and profibrozuyuchymy growth factors. The aim was to identify predictors of progression of chronic pyelonephritis in children to assess the level of kidney function in dynamic observation. Materials and Methods: Pediatric Nephrology at the Department of SI «Institute of Nephrology AMS of Ukraine» at the CST №7 of Kyiv was examined 191 child over 5 years in age from 3 to 17 years. Results: In the group of children with progressive chronic pyelonephritis relapsing course 2fi-MG urine compared with groups of 2fi-MG there PNhighest level of reliable patients who had not frequent relapses and recovered (p <0.001). To determine infringement tubular renal function, analyzed the $2-MG urine and serum levels with enzyme activity NAG, NAG B and in patients with chronic pyelonephritis and established significant coefficients of paired correlation 2fi-MG serum and urine $2-MG between levels and activity Nag, NagB in urine. Discovered reliable positive correlation between levels of albuminuria and TGF-fi, which is profibrotychnym factor (r = 0,48, p <0.001) and identified a significant increase in its levels in patients with chronic pyelonephritis. Conducted stepwise multiple linear regression analysis revealed a reliable connection between the measure glomerular filtration rate decline per year (which is determined by progression) and $2-MG levels of blood TGF-^, $2-MG in urine, albuminuria and indicators renoscintigraphy - ENPstand% inclusion RFP180 min. Conclusions. Predictors of progression of pyelonephritis in children are: increased activity of lysosomal enzymes, maintaining elevated levels $2-MG serum and urine regardless of the degree of inflammatory activity in the kidneys and albuminuria

Keywords

• pyelonephritis, children, p 2-microglobulin, albuminuria, lysosomal enzymes, chronicity and progression.