Savrun T. Clinical and pathogenetic features of hypoxic nephropathy in preterm infants

The dissertation deals with the pathogenesis, clinical course and diagnostic of hypoxic nephropathy based on the investigation of clinical and anamnestic, biochemical and immunological parameters of preterm infants , who were influenced by perinatal hypoxia and morphological kidney features of deceased newborns also included in the investigation. With a help of complex examination of preterm infants we have found clinical progression of hypoxic nephropathy depending on weight of body at birth. During the Doppler study, interruption of renal blood flow was found, especially decreasing of maximal flowing speed in magistral vessels and decreasing of pulse index, which were more expressed in the group of kids with body weight <1500 g at birth. Definition of Cystatine C in the blood serum, lipokalin, associated with neutrophils gelatinases and urine Interleukin-18 like a marker of early diagnostic of hypoxic nephropathy of preterm infants. Analysed connection of Cystatine C, lipokalin and Interleukin-18 with clinical manifestation of hypoxic nephropathy, renal blood flowing indexes and blood serum creatinin. The results of kidney”s morphological and immunehistochemical study of dead preterm infants with hypoxic nephropathy approved that signs of fibrose transformation and apoptosis which were found were more expressed in the group of kids with smaller gestational period and deep morphological immaturity. Based on discovered clinical, paraclinical and morphological features of hypoxic nephropathy, a pathogenesis scheme of hypoxic kidney damage of preterm infants was devised.