Trynduk J. Diagnostic and prognostic significance of proteinase activity of blood and urine in acute and chronic pyelonephritis in children

The work is dedicated to improvement of diagnosis and more effective prediction of the formation and progression of chronic pyelonephritis in children in advanced clinical and laboratory study of states of the system proteinase - proteinase inhibitor in blood serum and urine, lipid spectrum of blood serum, the immune system, renal haemodynamics. The system proteinase - proteinase inhibitor plays a significant role in pyelonephritis in children. The maximum activation of proteolysis occurs in an active phase of acute pyelonephritis and exacerbation of chronic pyelonephritis, which serves as a marker of inflammation. Identified changes in lipid metabolism, particularly phospholipid spectrum of blood serum in children with pyelonephritis, show evident structural, functional and membranopathologic changes of tubular and glomerular apparatus which lead to nephrosclerosis. More evident imbalance of proteinase - proteinase inhibitor system was revealed in children born with great body weight, especially in boys with acute pyelonephritis, and in girls with chronic pyelonephritis. More marked level of proteolysis activation took place in patients with nonobstructive chronic pyelonephritis in comparison with patients with obstructive one, and varying degrees of adaptive responses in acute and chronic pyelonephritis. The model involving examination of lipid spectrum and proteinase - proteinase inhibitor system in blood serum has been developed in order to predict the course and progression of pyelonephritis.