Предикторы и ранняя диагностика хронической болезни почек у детей

Abstract

Early diagnosis of progressive forms of chronic kidney disease (CKD), prevention of chronic kidney disease (CKD) in childhood, prevention of the development of complications and life-threatening conditions associated with impaired renal function still remain an unresolved problem in pediatrics and nephrology. The lack of informative clinical and paraclinical markers for predicting the course of CKD makes it difficult to diagnose the early stages of the disease, and the methods used in pediatrics for diagnosing kidney damage to assess the preclinical stages of structural and functional kidney damage are insufficienly informative. Determination of pathogenetic predictors of the course of chronic kidney diseases and biomarkers of early stages of kidney damage is prospective for solving this problem. Prognostic markers are factors or a group of factors that lead to the development and progression of the disease with an outcome in nephrosclerosis, the identification of which will improve the efficiency of CKD early diagnosis. We have scientifically substantiated that in children the leading criteria for the formation and progression of CKD are: an increase in the level of markers of endothelial dysfunction (endothelin-1, homocysteine, ADMA, serum cystatin) cytokine imbalance (increased pro-inflammatory IL-6, TNFά), combined with a decrease in GFR and parameters of intrarenal hemodynamics (diastolic blood flow velocity).