Prediction of progression of tubulointerstitial damage in children with reflux nephropathy

THE AIM of the study was to develop criteria for predicting of progression of tubulo-interstitial damage (TID) in children with reflux nephropathy. Patients and methods. Comparison of clinical, paraclinical data of 148 children aged from 1 year to 17 years, including patients with reflux nephropathy (n = 118) and control group (n = 30) was done. RESULTS. Progression of TID occurs stepwise increase in frequency of hypertension; reduce frequency of relapses of renal infection; reduction in GFR and tubular renal functions outcome in CKD; increase in the albuminuria / proteinuria; intrarenal hemodynamics reduction parameters: systolic blood flow velocity, diastolic velocity; increased excretion of proinflammatory cytokines IL-1, IL-6, IL-8, a proinflammatory TNF-α, TGF-β simultaneous stepwise reduction of urinary excretion of antiinflammatory IL-10. The contribution of immune factors in the progression of TIPP in patients with PH constitute to 42.1%. CONCLUSION. Prediction of progression of TID in children with reflux nephropathy is based on an assessment of the complex immunological, clinical and paraclinical factors allowing the deposit amount on the basis of the values of each of them with a probability of 80% to predict the progression of reflux nephropathy. Additional criteria for progression of tubulointerstitial kidney diseases are indicators: increase in daily urinary excretion of IL-1, IL-6, IL-8, TNF-α, TGF-β in reducing the daily urinary excretion of IL-10 in combination with a reduction of parameters of US Doppler, increasing levels of albuminuria / proteinuria, frequency of hypertension according to ABPM.

reflux nephropathy, prediction, progression, tubulointerstitial damage, albuminuria/proteinuria, cytokines

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