Progression of chronic kidney disease in children with glomerulopathy

BACKGROUND. Of particular scientific and practical importance are studies aimed at assessing the clinical features of the course and morphological signs of nephrotic and nephritic syndromes in children with chronic kidney diseases of the first and second stages. THE AIM: to assess the rate of progression of glomerulopathy in children depending on the treatment regimen. PATIENTS AND METHODS. 238 children aged 1–18 years with an established nosological diagnosis of kidney damage at various stages of CKD were examined, hospitalized for treatment in the Department of nephrology at the clinic of the Tashkent Pediatric Medical Institute in the period 2010-2022 and the National Children's Medical Center from 2021–2023. RESULTS. Children with CKD were divided into two subgroups: 146 children with nephrotic syndrome (steroid-sensitive, steroid-resistant or often recurrent) and 92 children with nephritic syndrome. More than half of the children have glomerulonephritis with minimal changes. In 25.4 % of cases, they were insensitive to steroid therapy. Among patients with nephritic syndrome, 46 % had IgA nephropathy. In dynamics, the most unfavorable picture was formed in children with focal segmental glomerulosclerosis. After 12 years of follow-up, 41.7 % of them developed terminal renal failure. The least effective treatment was noted with the use of cyclophosphamide, the best with the combination of tacrolimus with mycophenolate mofetil. CONCLUSION . Treatment regimens for children with glomerulopathy are still far from perfect.

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