DIABETIC NEPHROPATHY IN CHILDREN AND ADOLESCENTS: FEATURES OF DIAGNOSIS AND TREATMENT

The history of the discovery of pathological changes in the kidneys in diabetes mellitus (DM) goes back more than a century. In 1840, in the Paris hospital, C. Bernard, conducting a pathomorphological study of a patient with newly diagnosed DM, recorded a sharp increase in the size of the kidneys [1]. Later works showed an increase in kidney size in experimental diabetes [2]. Thus, it was suggested that nephromegaly is due to a state of hyperglycemia [3]. Since the discovery of insulin by Banting and Best in 1921, "late" diabetic complications began to determine the prognosis of the disease. Currently, diabetic nephropathy (DN) is the most formidable complication of DM, occupies a leading position in the structure of the contingent of adult patients requiring hemo- and peritoneal dialysis [4]. For a long time, nephropathy was diagnosed at the stage when the symptom complex of nephrotic syndrome developed and chronic renal failure (CRF) was formed. Since the 80s of the last century, the possibilities of diagnostics and treatment of preclinical stages of DN in children and adolescents have appeared [5]. Currently, it is known that DN in "juvenile diabetes" is the main cause of disability and mortality of patients. Research results show that the older the age at which diabetes was diagnosed, the lower the cumulative incidence of terminal stage CRF [6, 7].