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Abstract
FEATURES OF FORMATION AND PROGRESSION OF CHRONIC KIDNEY DISEASE IN CHILDREN WITH PYELONEPHRITIS AND VESICOURETERAL REFLUX
Morozova O.O.
Vesicoureteral reflux (VUR) is observed in 40% of children with pyelonephritis and is one of the leading causes of its recurrent course, which subsequently leads to chronic kidney disease. The purpose of this study was to determine the peculiarities of the formation and progression of chronic kidney disease in children with pyelonephritis and vesicoureteral reflux. The clinical material from 141 children aged from 6 months to 17 years with grade I-V VUR in the period of clinical and laboratory remission of pyelonephritis was analyzed. The study showed that the risk of developing scarring of renal parenchyma in children with high-grade VUR was 8 times higher than in children with grade I-II VUR. And the risk of developing scarring of the renal parenchyma in patients with grade V VUR is 3.8 times higher than in children with grade III-IV VUR. In recurrent pyelonephritis, the risk of scarring of the renal parenchyma is 1.8 times higher than in one episode of inflammation. In patients with a high grade of reflux, the risk of recurrent pyelonephritis is 2.6 times higher than in children with grade I-II VUR. In patients with pyelonephritis and high-grade VUR, with signs of systemic undifferentiated connective tissue dysplasia, the risk of developing scarring of the renal parenchyma is 33.9 times higher. Depending on the grade of VUR and the presence of signs of scarring of the renal parenchyma, the degree of CKD increases, which reflects the functional state and severity of pathological changes in the kidneys.
Formation and progression of chronic kidney disease in children with pyelonephritis and VUR depends on the course of pyelonephritis, the grade of VUR and presence of signs of scarring in the renal parenchyma.
Keywords.Vesico-ureteralreflux, renalscarring, pyelonephritis, children.
Резюме.
ОСОБЛИВОСТІФОРМУВАННЯ ТА ПРОГРЕСУВАННЯ ХРОНІЧНОЇХВОРОБИ НИРОК У ДІТЕЙ З ПІЄЛОНЕФРИТОМ ТА ВЕЗИКО-УРЕТЕРАЛЬНИМ РЕФЛЮКСОМ.
Морозова О.О.
Везико-уретеральний рефлюкс (ВУР) спостерігається в 40% дітей з пієлонефритом та є однією з провідних причин його рецидивуючого перебігу, що згодом призводить до хронічної хвороби нирок. Метою цього дослідження буловизначенняособливостей формування та прогресування хронічної хвороби нирок у дітей з пієлонефритом та везико-уретеральним рефлюксом. Проаналізовано клінічний матеріал 141 дитини у віці від 6 місяців до 17 років з I-Vступенями ВУР в періоді клініко-лабораторної ремісії пієлонефриту. Визначено, щоризик виникнення рубцювання ниркової паренхіми у дітей з високим ступенем ВУР у 8 разів вище ніж у дітей з ВУР I-IIступеню. А ризик формування рубцювання ниркової паренхіми у пацієнтів з Vступенем ВУР у 3,8 разів вищій ніж у дітей з III-IVступенем. При рецидивуючому перебігу пієлонефриту ризик рубцювання ниркової паренхіми в 1,8 разів вище ніж при одному епізоді запалення. В пацієнтів з високим ступенем рефлюксу ризик рецидивуючого перебігу пієлонефриту в 2,6 разів вище ніж у дітей з ВУР I-IIступенів. В хворих з пієлонефритом та ВУР високих ступенів, які мають ознаки системної недиференційованої дисплазії сполучної тканини ризик виникнення рубцювання ниркової паренхіми у 33,9 разів вище. В залежності від ступеню ВУР та наявності ознак рубцювання паренхіми нирок зростає ступінь хронічної хвороби нирок, що відзеркалює функціональний стан та виразність патологічних змін у нирках.
Формування та прогресування хронічноїхворобинирок у дітей з пієлонефритом та ВУР залежить від перебігу пієлонефриту, ступеню ВУР та наявності ознак рубцювання ниркової паренхіми.
Ключові слова:везико-уретеральний рефлюкс; діти, пієлонефрит, рубцювання ниркової паренхіми.
Резюме.
ОСОБЕННОСТИ ФОРМИРОВАНИЯ И ПРОГРЕССИРОВАНИЯ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК У ДЕТЕЙ С ПИЕЛОНЕФРИТОМ И ВЕЗИКО-УРЕТЕРАЛЬНЫМ РЕФЛЮКСОМ.
Морозова О.О.
Везико-уретеральный рефлюкс (ВУР) наблюдается у 40% детей с пиелонефритом и является одной из ведущих причин его рецидивирующего течения, что впоследствии приводит к хронической болезни почек. Целью этого исследования было определение особенностей формирования и прогрессирования хронической болезни почек у детей с пиелонефритом и везико-уретеральным рефлюксом. Проанализирован клинический материал 141 ребенка в возрасте от 6 месяцев до 17 лет с I-V степенью ВУР в периоде клинико-лабораторной ремиссии пиелонефрита. Установлено, что риск возникновения рубцевания почечной паренхимы у детей с высокой степенью ВУР в 8 раз выше чем у пациентов с I-II степенью. А риск формирования рубцевания почечной паренхимы у пациентов с V степенью ВУР в 3,8 раз выше чем у детей с III-IV степенью. При рецидивирующем течении пиелонефрита риск рубцевания почечной паренхимы в 1,8 раз выше чем при первом эпизоде воспаления. У пациентов с высокой степенью рефлюкса риск рецидивирующего течения пиелонефрита в 2,6 раз выше чем у детей с I-II степеню ВУР. У больных с пиелонефритом и ВУР высоких степеней, которые имеют признаки системной недифференцированной дисплазии соединительной ткани риск возникновения рубцевания почечной паренхимы в 33,9 раз выше. В зависимости от степени ВУР и наличия признаков рубцевания паренхимы почек возрастает степень хроничексой болезни почек, что отражает функциональное состояние и степень выраженности патологических изменений в почках. Формирование и прогрессирование хронической болезни почек у детей с пиелонефритом и ВУР зависит от течения пиелонефрита, степени ВУР и наличия признаков рубцевания почечной паренхимы.
Ключевые слова.Везико-уретеральный рефлюкс, рубцевание почечной паренхимы, пиелонефрит, дети.
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