The risk of disease recurrence (DR) after renal transplantation (Tx) is relatively high in children and may lead to graft loss (GL) representing 7 to 8% of all graft failures. Recurrence of the prior disease may be associated with either a high risk of GL (focal and segmental glomerulosclerosis, membranoproliferative glomerulonephritis, oxalosis, atypical hemolytic uremic syndrome) or with a low risk of GL (IgA nephropathy, SLE, ANCA-associated glomerulonephritis). Recurrence may also increase delayed risk of GL at such diseases as insulin-dependent diabetes mellitus and sickle cell disease. Adequate strategies should therefore be added to kidney Tx, such as pre-Tx genotyping, adequate donor selection, specific immunosuppression and/or biotherapy, combined liver and kidney Tx, etc. This will allow significantly enlarge waiting list because very few patients would be excluded from kidney Tx because of a major risk of DR. In the future, the issue of DR after kidney Tx may be resolved due to alternative treatment methods.

According to the native and foreign literature Strategy of corticosteroid and cytostatic treatment of relapsing and frequent relapsing steroid sensitive and steroid dependent (with steroid toxicity) minimal change nephritic syndrome (MCNS) in children on the onset stage is presented. Administrating details of alkylate compounds (chlorbutin, cyclophosphan), calcineurin synthesis inhibitors (cyclosporine A), nucleotide synthesis inhibitors (mizoribine, micophenolate mofetil) of MCNS in children was discussed. Clinical experience and new scientific findings stipulated change tactic of choice of immunosuppressive preparation, its dosage and treatment duration in MCNS in children.

Using of treatment protocol allow to optimize and adequately control the program of child therapy after kidney transplantation. Present article express all stages of preparation and treatment of children before, during and early postoperative period of time.

Literature review summarize features of amyloid nephropathy in children and adult patients with rheumatoid arthritis, discuss the diagnostic value of the serum amyloid precursor protein (SAA) levels in blood.

The article shows the main stages of introduction and organization of dialysis therapy and kidney transplantation for children in the Republic of Belarus, the procedure of examination of patients on the renal graft waiting list and the experience of the first 55 kidney transplantations made in Belarus from April 6, 2009 to January 1, 2013.

Purpose is to define immunogenetic features among children with kidney transplants and factors that determine the duration of renal transplant functioning. Results of 47 renal allografts, made between 1996 and 2010 were analyzed, among them - 17 from living related donors, 30 - cadaveric allografts. Observation time duration is from 1 year to 13 years. Recipients’ age from 9 to 19 years. It is found that the duration of transplant kidney functioning, transplanted in children, increases with the matches in pairs of donor - recipient at loci HLA-A and HLA-DR. There are determined combinations of major histocompatibility complex alleles, which have a beneficial or adverse effect on the course of post-transplant period. In post-transplantation period in time of three to four years during immunosuppressive therapy activation of cellular and humoral components of immune system and the highest level of renal graft loss are specified.

AIM OF STUDY. To estimate the characteristics of renal and extrarenal manifestations of autosomal dominant polycystic kidney disease (ADPKD) in children. PATIENTS AND METHODS. 67 children from 60 families with ADPKD were involved in research. Data of follow-up, clinical, laboratory and instrumental examinations were used. Stratification of chronic kidney disease (CKD) according to NKF-K/DOQI classification (2002) and national recommendations (2012) was carried out. RESULTS. The agespecific features of renal cysts diagnostics by ultrasound were detected: 0-15 years in 91%, including 0-18 month (very early onset) in 19,4%; 15-18 years in 9%. Bilateral location of renal cysts dominate: at first detection (mean age 8,24±0,64 years) in 59,7%, at follow-up moment (mean age 13,2±0,54 years) in 95,5%. Regression analysis revealed that in ADPKD children annual increase of maximal diameter of renal cysts by ultrasound (US) scan was 0,21±0,03 cm, annual increase of average renal length by US scan was 0,42±0,05 cm. Arterial hypertension (AH) was diagnosed at first detection of cysts in 4,5%, at follow-up in 21%. Average renal length and maximal diameter of renal cysts in ADPKD children with AH is significantly larger than in ADPKD children without AH. There are no significant differences between average renal length, maximal diameter of renal cysts and AH frequency in children with very early and later detection of cysts. Extrarenal manifestations of ADPKD in children at followup (5,1±0,6 years) are significantly more often (31,3%), than at first renal cysts detection (13,5%). It was demonstrated that computer tomography and magnetic resonance imaging are significantly more informative methods for detection of extrarenal cysts than US scan. In ADPKD children I stage of CKD dominates in 94%. CONCLUSION. Characteristics of renal and extrarenal manifestations, course and outcome of ADPKD in children were revealed.

THE AIM of this study is to reveal clinical significance of definition of free hydroxyproline (FH) and peptid-legate (HPL) level excretion in urine in children with reflux nephropathy. PATIENTS METHODS. The study group consisted of 71 (52 girls) patients aged 5.69±0.44 y. with vesicoureteral reflux (VUR). All patients were divided on 3 groups by the results of DMSA-scintigraphy: 9 children with VUR without focal sclerosis (2 group), 41 patient with 1-2 stage of reflux nephropathy (RN) (1-3 focal sclerosis, 3 group) and 21children with 3-4 stage of RN (> 3 focal sclerosis, 4 group). 10 healthy children served as control (1 group), aged 6.24 ± 0.31 y. Urinary excretion and ratios over creatinine of FH and HPL were measured. RESULTS. Both urinary levels of FH and HPL in patients with RN were higher compared to the control group (p<0.05). The highest urinary concentration of FH was found in subgroup 3 and 4 (p<0.05). HPL in the urine of children with severe RN were twice higher than in the control group and subgroup 2 (p<0.05). CONCLUSION. The levels of FH and HPL in urine are dependent on the degree of focal sclerosis in patients with VUR. We therefore recommend determination of concentration of HPL and, especially of FH in children with VUR for RN diagnostics.

This article discusses the possibility of using a new marker for the determination of renal function in pediatric patients - cystatin C. AIM OF STUDY: to determine the glomerular filtration rate using different methods of creatinine, as well as a new marker of kidney injury - cystatin C in children. PATIENTS AND METHODS: 83 patients from 1 month to 17 years (mean age 4,15 ± 5,08 years) with various nephropathies were examined. RESULTS: were determined the serum concentration of cystatin C (1,3 ± 0,38 mg/l), creatinine (0,62 ± 0,72 mg%) and glomerular filtration rate (GFR) using formulas based on creatinine and cystatin C. We conducted a comparative analysis of glomerular filtration with different methods of study. CONCLUSION: The serum concentration of cystatin C is independent of sex, and its higher level is determined in the first year of life. The most important for practical use in pediatrics are formulas using cystatin C and creatinine.

The article presents a follow-up monitoring of children with Bartter syndrome and Gitelman syndrome - tubulopathies with autosomal – recessive fashion which manifest by hypokalemia, metabolic alkalosis, convultions, growth restriction, hypomagnesemia in Gitelman syndrome. The features of the course of primary and secondary Bartter syndrome, as well Gitelman syndrome, are descibed.

Authors describe a case of diagnostic of proximal renal tubules congenital dysgenesis leaded to chronic kidney disease in newborn. Diagnosis was morphologically proved at the age of 11 days, including immunohistochemical study of kidney biopsy specimen with monoclonal antibodies to epithelial membrane antigen. Automatic peritoneal dialysis and veno-venous hemofiltration were started at the age of 3 days with positive effect. The successful kidney transplantation was done in 4,1 years old child.

This article describes clinical manifestations of methylmalonic acidemia (MMA) with tubulointerstitial nephritis in two siblings from the same family. Typical signs are: an aversion to the protein (nausea at the smell of boiling meat), recurrent attacks of headache, anorexia, vomiting, visual and auditory hallucinations, convulsions, hyperammonemia, increase of methylmalonic acid in urine. Discussed therapy and outcome.