The review presents features of classification, epidemiology, diagnostic and outcome of acute kidney injury in children, unsolved problems.

Literature review summarizes features of anemia syndrome treatment in children with chronic kidney disease.

The disturbances of physical development in children are early diagnostic and prognostic markers in different diseases, for example in chronic kidney disease (CKD). For comparative evaluation can be used standards of normal physical development in children designed by World Health Organization (WHO) using hard standardized approaches in 1997-2003 years, or regional reference charts. Height of children with CKD Severe growth impairment is significantly below than in general pediatric population. The results of the weight in children with CKD are contradictory, in glomerular diseases patients often have overweight and obese. Following factors can influence over height in children with CKD: etiology of nephropathies, which leaded to CKD, age at CKD onset, metabolic acidosis, kidney function, some genetic factors and intrauterine development factors. Therefore, the patients need treatment directed at acidosis compensation, inhibiting nephratonia, and at severe growth deficiency - growth hormon therapy. The disturbances of physical development in children with CKD should be determined as soon as possible to provide early correction of physical development in patients. It is important to define the prognostic factors for physical development in children and adolescents with CKD, including not only disease signs but also genetic and intrauterine factors.

Review presents the present knowledge of the new markers for diagnostics and monitoring the activity of lupus nephritis in children, which can be used in practice of pediatric-nephrologist to optimize the treatment and determine its duration.

Literature review summarizes features of the course and outcomes, the strategy of current treatment of Mid aortic syndrome, affected by severe hypertension in children.

Clinical observation of patient with multiple malformations - VACTERL association (OMIM 192350) is presented: V (segmentation disturbance of Th 4-12 and ribs, congenital vertebral kyphoscoliosis, gidromiyeliya, coccyx cyst), C (dextrocardia), T (tracheoesophagial fistula), E (esophagus atresia), R (hydronephrosis of right cross-misplaced kidney, two-dimensional dystopia of a right kidney, vesicoureteral reflux IV), L (varus deformation of the lower extremities). Diagnostics, differential diagnostics and therapy are discussed.

AIM OF RESEARCH: Тhe purpose of investigation is to study the clinical and morphological and immunological characteristics of glomerulonephritis (GN), associated with persistent herpes virus infection of 1, 4, 5 types. PATIENTS AND METHODS: 75 children from 1 to 18 years with primary GN, associated with 1,4,5 type herpes virus infection are included in investigation. The methods are: morphological, immunoserological, immunocytochemical and immunohystochemical and molecular-biological (PCR). Flow cytometry method was used for investigation of lymphocytes subsets (67 patients). RESULTS: Тhe active herpes virus infection of 1,4,5 types is revealed in 97% of all children with GN, clinical symptoms of atopy - in 32%; decreased level of antivirus protection-in 55%, the secondary immunodeficiency state - in 20%. CONCLUSION: The GN, associated with herpes virus infection is characterized by immune disturbances, which affect the cell-mediated immune response, which provides antivirus immunity in normal state. The role of flow cytometry method in diagnostics of immunological disturbances is demonstrated, the use of antivirus and immunomodulatory therapy is explained.

PURPOSE OF THE RESEARCH: to investigate the polymorphism of genes associated with inherited thrombophilia in children with nephrotic syndrome, primary and secondary glomerulonephritis (GN). PATIENTS AND METHODS. In 151 patients (31 with hormone-sensitive nephrotic syndrome (NS); 95 with primary chronic GN and 25 patients with secondary GN in systemic vasculitis) were investigated allelic variants of the genes of factor V (G1691A, FV Leiden), factor II (prothrombin, G20210A), methylentetrahydrofolate reductase (MTHFR C677T), factor I (fibrinogen, G-455A), an inhibitor of plasminogen activator (PAI-I -675 4G/5G) and glycoprotein IIIa (GpIIIa, TS). RESULTS. Mutation FV Leiden detected in 9 (6,0%) patients of the total group, which is slightly higher than healthy. The high frequency of this mutation characterized patients with NS - 12,9% (OR=3,2; p=0,05). The mutation in the prothrombin gene was detected in two patients of total group (1,3%) compared with 2.2% in the control. A small number of homozygotes for allele 677T MTHFR gene registered in the total group of patients - 6 (4,0%) compared with 10,1% in the control group (0R=0,4; p=0,03). No one patient with NS with this genotype was detected. The proportion of individuals with the homozygous genotype GpIIIa 1565CC in the total group of patients was 4.0% against 0.9% in the healthy group (0R=4,7; p=0,04). The high frequency of this genotype was detected in patients with secondary GN in systemic vasculitis (12,0%, 0R= 15,4; p <0,01), in contrast to patients with NS in which this genotype was not met. The proportion of heterozygotes in GpIIIa gene was highest in patients with NS - 38,7 % and the lowest in patients with glomerulonephritis in systemic vasculitis - 12,0% compared to 32,0 % in the control (0R=0,3; p=0.,04). CONCLUSION. High frequencies of mutation FV Leiden characterized patients with NS to 12,9% (0R=3,2; p=0,05).

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.

AIM OF RESEARCH: To study in chronic experiments on rats pathomorphological changes in kidney in urinary tract infection. MATERIALS AND METHODS: In experimental on rats used pyelonephritis modeling method, which reproduced by introducing daily culture E. Coli in the amount 200-500 mln. microbic bodies into ureter lumen, with its subsequent ligation. RESULTS: It is established that in all observation time after simulated pathological processes considerable morphological changes mainly occurred in the kidneys tubules and interstitial. The changes presented with signs of infiltrative-productive inflammation as well as fibrosis of different levels of intensity. CONCLUSION: A definite correlation between the type of simulated pathological process and the intensity of morphological changes in the kidneys was revealed. Microscopic changes can serve as criteria of kidneys parenchyma involvement in the pathological process as well as to become an important prognostic sign.