FUNCTIONAL PORTRAIT OF THE KIDNEY IN CHILDREN WITH TUBULOINTERSTITIAL LESIONS

Abstract

Among 186 examined children there were 74 children with different forms of pyelonephritis (PN) and 112 children with tubulo-interstitial nephritis (TIN). The parameters of the functional condition of the kidneys in children were estimated in the acute period of illness, during the formation of clinico-laboratory remission, in a year and 3 years after the acute period. Mathematical modeling of the kidney function condition was carried out by the method of a systemic multifactorial analysis (SMA). The impairment of the kidney function in all the patients occurred due to its tubular component that manifested itself in the impaired function of the proximal and distal tubule (reduced reabsorption of the tubules and concentration ability, parameters of acido-and ammoniogenesis, increased diurnal proteinuria). The assessment of nephroscintigrams with the tubulotropic preparation MAG-3 has confirmed the data obtained. No impairment of the azoteliminating function and electrolyte structure of blood were revealed. The SMA has confirmed the primary impairment of tubular functions. The designed weight factors and integral parameters reflected a tubular dysfunction. In the acute period of PN the functional condition of the kidney was reduced due to the impaired concentration function and that of the distal tubule. In children with chronic PN and TIN the degree of impairment of the functional condition of the kidneys was higher during the longer process in renal tissues (inflammation in tubulo-interstitial tissue of the kidney, sclerotic processes in the tubules).