Clinical and laboratory markers of structural and functional disorders in the formation of chronic kidney disease in young children, treatment effectiveness

Diseases of the urinary system in children are a pressing problem due to the development of chronic kidney disease. Purpose. To identify predictors of the development of chronic kidney disease in young children, develop a treatment and rehabilitation complex and evaluate its effectiveness based on the dynamics of structural and functional disorders of the urinary system. Material and methods. 69 children (14.5 ± 9.6 months) with aged kidney diseases and 35 children (11.7 ± 5.9 months) of the control group without kidney disease were examined. Results. 76.1 % of children have chronic secondary pyelonephritis, their likelihood increases if the mother has a history of pathology of the placenta the blood and digestive organs; when these are combined with gestational diabetes mellitus, there are relationships with congenital hydronephrosis, pyelocalicectasia, vesicoureteral reflux, with a reliability of the model of 86 %. Relationships between VEGF-A and urinary syndrome, indicators of renal blood flow in children with unfavorable maternal medical history factors were found. Conclusion. Somatic pathology, diseases of the placenta and gestational diabetes mellitus in the mother’s history increase the likelihood of pathology of the urinary system and are associated with hydronephrosis, pyelocalicoectasia, vesicoureteral reflux in children. VEGF-A levels may be markers of an unfavorable or favorable course of pyelonephritis. 26 % of children with secondary pyelonephritis require surgical correction. The complex, including antibiotics, calcium metabolism regulators, diuretics of plant origin (Canephron N), physiotherapy, influenced the restoration of the structures and functions of the kidneys.