Lytvynova O. Clinical-morphological description and prognosis of hematuric variant of chronic glomerulonephritis in children.

The thesis is devoted to issues of efficiency increase of diagnostics and prognosis of clinical course of hematuric variant of chronic glomerulonephritis (HVCGN) in children on the basis of study of clinical and morphological features of the disease, post-treatment effects. Dynamics of clinical and laboratory indices of HVCGN in children depending on the length of the disease is defined. Rate and character of ultrasonographic kidney changes in HVCGN children at different lenght of the disease is determined. According to data of lifetime morphological kidney examination in children with HVCGN it has been proved that main morphological form is a mesangioproliferative glomerulonephritis, usually related to IgA-nephropathy. Rate of hyalinosis and sclerosis of glomerulis, tubule-intersticial changes was defined. On the basis of clinical morphological comparisons morphological equivalents of clinical symptoms of HVCGN in children are presented. Rate of development of chronic kidney failure (CKF) at different HVCGN duration on the basis of defining CKF patients percentage from the general amount of the persons examined and estimation of relative value of intensity of CKF occurrence for 100 patient-years was determined. Such factors of HVCGN poor prognosis as burdeness of anamnesis in nephropathies, arterial hypertension, proteinuria, increase of blood serum creatinine, ultrasonografic changes in a form of corticomedullar kidney differentiations loss, hyalinosis and sclerosis of glomerulis, macrofocal infiltration in intersticial tissue were found out. Mathematical models of CKF formation prognosis at different HVCGN duration and also in accordance with the nephrobiopsies data, that allows children's nephrologists to administer at the proper time renoprotective therapy, the purpose of which is deceleration of disease aggravation, were worked out.