VITAMIN D NEPHROPROTECTIVE STRATEGY OF CHILDREN WITH CHRONIC RENAL DISEASE

Abstract

According to current conception, the process of forming of nephrosclerosis despite the origins is detected by the force of the same cellular and molecular mechanisms. Hence primary triggers cause elevated production of range of cellular response mediators, cytokines and growth factors such as transforming plateled-derived growth factor, fibroblast growth factor, interferon gamma, nuclear factor and others, by means of sequential processes, is followed by the replacement of kidney tissue. One of the most studied aspects of the process of nephrosclerosis is the influence of anginotensin II. Therefore, despite the triggering factors, development and progression of nephrosclerosis all children with chronic renal disease are in a risk group with predisposition for renal insufficiency and it is required to prescribe nephroprotective therapy, i.e. the drugs that will influence one of the links of the nephrosclerosis, in order to slow down its progression. Currently, with nephroprotective goal in early age are used the following elements - angiotensin converting enzyme inhibitors and angiotensin receptors, antogonists (blockers). Lately, the active search for effective and safe drugs with nephroprotective effect on one side and great interest towards undiscovered before qualities of Vitamin D caused a huge amount of works that support the effect of Vitamin D. Prescription of Vitamin D to animals with uremia was followed by the drop of apoptosis of podocides and loss of the protein that is contained in the split diaphragm that caused decrease in proteinuria. Vitamin D suppresses protophibrotic TGF-B1 in tubular epithelial cells. The regression of tubulointerstitial phibrosis under the influence of Vitamin D was confirmed based on the cases of animals with obstruction of urethra. Along with the use of the mentioned above groups of drugs, which effectiveness was proved experimentally and clinically, we strongly believe the more thorough study of the Vitamin D drug use is needed, especially to study the prevention and slowing down of the progression of nephrosclerosis in the cases of children with chronic renal disease. It is crucial to detect the exact dosage of the drug, the prescription period and the methods for the control of the effective concentration of the drug.