PECULIARITIES OF STRUCTURAL-FUNCTIONAL STATE OF THE KIDNEYS ACCORDING ELASTOGRAPHY SHEARWAVE IN CHILDREN WITH ARTERIAL HYPERTENSION ON THE BACKGROUND OF OBESITY

Abstract

Introduction. Metabolic and hemodynamic consequences of obesity (insulin resistance and hyperglycemia, hypertension, dyslipidemia) rofm metabolic syndrome in adolescence and an accordingly high risk of cardiovascular morbidity and mortality in adulthood. In recent years, studies have shown that obesity and metabolic syndrome are independent risk factors for chronic kidney disease (CKD). Ultrasonography is the most commonly used noninvasive method for research of the kidneys in pediatric patients.Aim of the study: to assess new features of shear wave elastography for the diagnosis of structural-functional state of the kidneys in children with arterial hypertension and obesity. Materials and methods. Ultrasound examination of kidneys was performed using a digital portable ultrasound system ANGIODIN - sono / P - Ultra (NPF “BIOS” Russia). Was examined 83 children who underwent elastography shear wave parenchymal layer of the kidney definition of renal parenchymal stiffness in kPa.Results. In patients with arterial hypertension and obesity the results of elastography, shear waves we found significant differences in the elasticity of the renal parenchyma between those with arterial hypertension (group 1, n=37) and children with uncomplicated obesity (group 2, n=26). The elasticity of the renal parenchyma in patients of the control group (n=20) was significantly lower than in patients of the 1st and 2nd groups. The results show that in children of the 1st group with stable hypertension high values of the elasticity of the renal parenchyma were detected in 3,2 times more often in comparison with children of the 1st group were diagnosed with labile hypertension. Conclusion. The shear wave elastography is an informative noninvasive method of evaluation of the kidneys in children with arterial hypertension with obesity. This diagnostic approach can be used in pediatric patients as a screening method (before ABPM) to assess the risk of developing hypertension, degree of hypertension and the adequacy of current anti-hypertensive therapy.