Yarovaya K. Clinical-pathogenetic description of glomerulonephritis in children on the background of modern treatment methods (clinical-experimental investigation)

Subject of the study: glomerulonephritis. Purpose of the study: Improvement of acute glomerulonephritis' treatment in children on basis of profound clinical and experimantal study of the age peculiarities of phospholipids and inositolphosphats metabolism in formation of nonimmune aspects of disease, optimisation thier medicamental correction. Methods of the study: Thorough clinical examination and common laboratory analyses have been performed for verification of diagnosis. Levels of IPh in leucocytes of blood, total PhLs and their fractions, MDA, DC, SH-groups in blood plasma, phospholipase A in erythrocytes and leucocytes were examined. Modeling of autoimmune GN in rats and studing of of IPh levels in kidney's cells, blood lymphocytes and platelets PhL's composition of membranes, levels of ionized Ca, ATPh, SDG, ICDG, GK of renal cells have been investigated also. Novelty: Peculiarities of IPh content in blood leucocytes at children with acute GN dependeg in dependence upon patients' age, activity and severity of disease have been established. In experimental part of work in conditions of modeling of autoimmune GN's in rats of 1, 3, 6 months were received results, testifing presence of age peculiarities of PhL metabolism, membrane destructer processes and providing of renal cells with energy. Reveling of similar changes of IPh metabolism in renal homogenates and peripheral blood cells in experimental GN allowed to propose studyng of fractional composition of leucocytes' IPh for characteristics of metabolic processes in kidneys of children with GN. On the basis of esteblishment of interlationships between changes of PhL metabolism with degree of membrane's disorders, severity and activity of GN, revealing of trustworthy correlation between PhL metabolism, POL and immune system the role of IPh in non-immune mechanism of GN's pathogenesis is proved. Practical significance of the obtained findings: For improvement of diagnostics' quality, prognosing of course and effectiveness of therapy control in children with acute GN in complex evaluation of clinical and laoratory indices examination of IPh in blood leucocytes is expedient. Disorders in IPh metabolism, which were revealed in this investigation and have marked pathogenetic meaning, is necessery to take into account as important criterion of development and progress of acute GN in children. Positive effect of IACE and antioxydants (vit E, dimephosphon) use on PhI metabolism allows to recommend above mentioned combinations of drugs for treatment of acute GN in children. Degree of introduction: The findings of the research were introduced into the work of nephrology department of City Children's Clinical Hospital No. 16 (Kharkiv), City Children's Clinical Hospital No. 2 and 6 (Dnipropetrovsk), Children's Territory Medical Department (Evpatoria), nephrology departments of regional children's hospitals (Kharkiv), Donetsk, Zaporizhzhia, Ivano-Frankivsk, Lugansk). Sphere of application: medicine, pediatrics, nephrology.