nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2021-25-3-9-19nefr-1970Research ArticleПЕРЕДОВАЯ СТАТЬЯLEADING ARTICLEПедиатрические проблемы стратификации тяжести стадий, сердечно-сосудистых осложнений и почечного прогноза хронической болезни почек по классификациям NKF-K/DOQI (2002) И KDIGO (2012)Pediatric problems of stratification of the severity of stages, cardiovascular complications and renal forecast of chronic kidney disease by NKF-K / DOQI (2002) and KDIGO (2012) classificationshttps://orcid.org/0000-0002-9415-4785СавенковаН. Д.SavenkovaN. D.

Савенкова Надежда Дмитриевна, д-р мед наук  кафедра факультетской педиатрии, заведующая

194100, Санкт-Петербург, ул. Литовская, д. 2.

Тел.: (812) 4165286

Prof. Nadezhda D. Savenkova, MD, PhD, DMedSci Affiliations, faculty pediatric, Head of the department

194100,  St-Petersburg, Lytovskay st., 2Phone: (812) 4165286

Savenkova.n.spb@mail.ruhttps://orcid.org/0000-0003-4353-2237ГригорьеваО. П.GrigorevaO. P.

Григорьева Ольга Павловна, канд мед. наук, кафедра факультетской педиатрии, ассистент

194100, Санкт-Петербург, ул. Литовская, д. 2. , . Тел.: (812) 4165286

Olga P. Grigoreva, MD, PhD Affiliations,  faculty pediatric, Assistant

194100, St-Petersburg, Lytovskay st., 2Phone: (812) 4165286

opgrigoreva@mail.ruСанкт-Петербургский государственный педиатрический медицинский университетРоссияSaint-Petersburg State Pediatric Medical UniversityRussian Federation202122042021253919Copyright © Савенкова Н.Д., Григорьева О.П., 20212021Савенкова Н.Д., Григорьева О.П.Savenkova N.D., Grigoreva O.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1970

Хроническая болезнь почек (ХБП) у детей является глобальной мировой проблемой. В статье вынесены на обсуждение проблемы стратификации тяжести ХБП по классификациям National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) (2002) и Kidney Disease Improving Global Outcomes (KDIGO) (2012) у педиатрических пациентов. Существуют ограничения в оценке тяжести стадий ХБП С1-5 по NKF-K/DOQI (2002) и KDIGO (2012) у детей до 2 лет, имеющих низкую величину скорости клубочковой фильтрации в отличие от взрослых. Обсуждены стратификация тяжести стадий 1-5 ХБП, сердечно-сосудистых осложнений и почечного прогноза у детей и подростков по классификациям NKF-K/DOQI (2002) [3] и KDIGO (2012) [14]. У взрослых пациентов с ХБП вескими аргументами за выделение в 3 стадии ХБП по KDIGO (2012) подстадий С3а и С3б явилось то, что почечный и сердечно-сосудистый прогнозы различны при СКФ 45-59 мл/мин/1,73 м 2и СКФ 30-44 мл/мин/1,73 м 2 . Прогноз риска развития сердечно-сосудистых болезней и осложнений по стадиям С2-5 в соответствии с классификацией KDIGO (2012) у детей и взрослых имеет различия. Как следует из публикаций, дети с ХБП в додиализных стадиях С2-4 формируют группу высокого риска, с С4–5 на диализе группу очень высокого риска осложнений, связанных с сердечно-сосудистой патологией. Сердечно-сосудистые осложнения составляют более 30 % среди всех смертей педиатрических пациентов с ХБП С4–5 на диализе. Приведены аргументы, обосновывающие выделять стадии ХБП С1–5 у детей старше 2 лет и подростков в соответствии с классификацией NKF-K/DOQI (2002).

Chronic kidney disease (CKD) in children is a global problem worldwide. The article discusses the problem of stratification of CKD severity according to the classifications of the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K / DOQI) (2002) and Kidney Disease Improving Global Outcomes (KDIGO) (2012) in pediatric patients. There are limitations in assessing severity of CKD stages C1-5 according to NKF-K / DOQI (2002) and KDIGO (2012) in children under 2 years of age who have a low glomerular filtration rate in contrast to adults. The stratification of the severity of stages 1-5 of CKD, cardiovascular complications and renal prognosis in children and adolescents according to the classifications NKF-K / DOQI (2002) [3] and KDIGO (2012) [14] are discussed. In adult patients with CKD, there is a compelling case for identifying of C3a and C3b sub stages in 3 stages of CKD according to KDIGO (2012) was that renal and cardiovascular prognosis are different with GFR 45-59 ml/min/1.73 m 2and GFR 30-44 ml/min/1.73 m 2 . The prognosis of the risk of developing cardiovascular diseases and complications for stages C2-5 in accordance with the KDIGO classification (2012) in children and adults differ. As follows from the publications, children with CKD in the pre-dialysis stages C2-4 form a high-risk group, with C4-5 on dialysis a group of very high risk of complications associated with cardiovascular pathology. Cardiovascular complications account for more than 30 % of all deaths of pediatric patients with CKD C4-5 on dialysis. The arguments justifying the allocation of CKD stages C1-5 in children under 2 years of age in accordance with the classification of NKF-K/DOQI (2002) are presented.

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The authors declare that there are no conflicts of interest present.