Zdorovʹe Rebenka (Feb 2018)
Dysmetabolic nephropathy as a risk factor of pylonephritis in children
Abstract
Background. Dysmetabolic nephropathies contribute to the development of urinary stone disease in children, the emergence of an infection of the urinary system, secondary pyelonephritis and formation of tubulo-interstitial changes in the kidneys. The main purpose of the research was to analyze the incidence and structure of dysmetabolic nephropathies as a risk factor of pyelonephritis formation in children in the Dnipropetrovsk region. Materials and methods. The study included analysis of 297 cases of dysmetabolic nephropathies in children. All the patients underwent general clinical examination, ultrasound examination of the urinary system and laboratory examination. Results. There was a significant prevalence of girls (72.6 %) compared with boys (27.4 %). Furthermore, oxalate dominated in the structure of nephropathies with the recorded isolation in 88.1 % of all the children. Oppositely, phosphate and urate dysmetabolic nephropathies occurred significantly less frequently, both alone and in combination with oxalate nephropathies. An increase in the number of children with dysmetabolic nephropathy regarding to the age was evident. However, the specific gravity of oxalate, phosphate and urate dysmetabolic nephropathy with the age did not change significantly and was approximately the same in all age groups. In 73 % of cases, dysmetabolic nephropathies were associated with infectious and inflammatory diseases of the urinary system. Consequently, more than two thirds of children (68.9 %) had pyelonephritis. There was a combination of dysmetabolic nephropathy with acute pyelonephritis in a half of children of early age. The specific gravity of acute pyelonephritis decreased and the number of chronic pyelonephritis increased gradually depending on the age (for example, more than half of children (58.3 %) the group of 11–17 years had chronic pyelonephritis in). There was also the correlation between the prevalence of dysmetabolic nephropathy among children of the Dnipropetrovsk region and their residence. Conclusions. There is a high incidence of dysmetabolic nephropathies with the predominance of isolated oxalate-calcium ones in children population. Dysmetabolic nephropathy in children of the first years of life, especially in girls, is a risk factor of infectious and inflammatory diseases of the urinary system. In addition, the detection of dysmetabolic nephropathies is more frequent in large industrial ecologically polluted centers of the region.
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