ESPN 51th Annual Meeting

ESPN 2018


 
RENAL FUNCTIONAL RESERVE IN CHILDREN AND ADOLESCENTS WITH PYELONEPHRITIS, URETERAL OBSTRUCTIONS AND REFLUX
IRINA BALALAEVA 1 TATYANA STEPANOVA 1 ANATOLY SHVYREV 1

1- VORONEZH N.N.BURDENKO STATE MEDICAL UNIVERSITY
 
Introduction:

 The objective of this study was to determinе the frequency of changes of renal functional (filtration) reserve (Rfr) in children and adolescents with pyelonephritis, obstructive uropathiеs and vesicoureteral reflux (vur).

Material and methods:

 180 studies of RFR were carried out in patients aged 3 to 17 years with pyelonephritis in the setting of hydronephrosis / ureterohydronephrosis (67), VUR 1- 4 grade (113). RFR determined by the change of glomerular filtration rate with oral loading of boiled meat protein.

Results:

 Rfr was less than 10% or absent after the protein load in 47.8% of patients with obstructive uropathies, in 48.7% of patients with VUR. Changes of the RFR was observed more often in girls than in boys (Р<0.001). In girls with VUR the RFR impairment was registered 3.6 times more often than in boys. The lack and reduction of the RFR were often noted in boys after nephrectomy (73.3%); in children with kidney diseases revealed in the first year of life (63.4%). In patients with reduced concentration function changes of the RFR was registered significantly more often (60.5%) than with normal function (P <0.001). The changes of RFR was not affected by the age of the patients and the stage of pyelonephritis.

Conclusions:

 A large frequency of the RFR impairment indicating hyperfiltration and the possibility of an unfavorable prognosis was noted in girls with pyelonephritis and VUR, in nephrectomic boys, in children with kidney diseases recognized in the first year of life, in patients with reduced concentration function.