Состояние почечного кровотока при гломерулонефрите у детей

Abstract

The aim of the work was to assess the state of hemodynamics at different levels of the renal artery in children with different forms of glomerulonephritis. The investigation included 74 children with glomerulonephritis and 15 practically healthy children aged between 3 and 15 years. The children were divided into three groups: 1 - children with nephrotic syndrome of acute glomerulonephritis, 2 - children having nephrotic syndrome with hematuria and 3 - children with the nephrotic forms of chronic glomerulonephritis. Disturbed renal hemodynamics was noted in all the groups. More pronounced impairments of the renal hemodynamics were noted in the nephrotic form of CGN charcterized by considerably lower vascular resistance at the arcuate artery level. The resistance indices in the large vessels were not disturbed in patients with exacerbation of CGN. The data obtained suggest that disturbances of the renal hemodynamics depend not only on activity of GN but also on the course of the disease. In the absence of extrarenal manifestations the blood flow was altered mainly in small (arcuate) arteries of the kidneys and has Iowerindicesof vascular resistance. Thus, in the active period the blood flow was disturbed in all variants under consideration. But it was better preserved in patients with the hematuric form of GN. The state of renal blood flow in GN was disturbed at different levels. The greatest disturbances were noted in small arteries of the kidneys - interlobular and especially arcuate. The blood flow in large arteries can remain normal. In the edematous period in the nephrotic form of chronic glomerulonephritis the disfurbancea of the renal blood flow are characterized by the elevation of the indices of vascular resistance, first of all in the renal artery trunk. Thelatter is combined with parenchymal edema and increased size of the kidneys.