Zdorovʹe Rebenka (Oct 2016)
Possibilities of the Early Diagnosis of Nephrosclerosis in Children Up To 3 Years in the Period of Complete Remission of Acute Uncomplicated Pyelonephritis
Abstract
When the diagnosis of pyelonephritis has been confirmed, primarily the level of sclerosis and chronic renal pathology formation, caused by inflammation process, needs to be determined. Markers of undifferentiated connective tissue pathology and glomerular part of the nephrons in children, which are the indicators of the oxyproline, creatinine and glycosaminoglycan levels, take the leading place in this process. Aim: early diagnosis of nephrosclerosis formation in children up to 3 years of age with acute uncomplicated pyelonephritis without anatomical congenital urinary tract defects in the period of its complete remission. Materials and methods. We have examined 65 children with acute pyelonephritis in the period of complete remission, without any anatomic developmental urinary tract defects. Children underwent general clinical examination, evaluation of the markers of functional state of the tubular epithelium and glomerular part of the nephrons, oxyproline in the urine, urinalysis. Results. Urinalysis tests revealed higher frequency of excretion of all indicators in the urine of children in the main group in comparison with healthy children. The creatinine level in the urine of patients with pyelonephritis was lower in 21.5 % of the examinees as compared to 2.5 % of healthy children. 9.2 % of the children with pyelonephritis had elevated levels of oxyproline, which is the marker of connective tissue dysfunction in the renal parenchyma. Glycosaminoglycan secretion analysis reveals that in children of all age groups with pyelonephritis, it was not significantly higher. Conclusions. With the aim to predict the formation and early diagnosis of nephrosclerosis in young children with pyelonephritis, it is strongly recommended to use such markers, as the results of the tests for urinalysis, creatinine excretion and oxyproline in the daily urine.
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