Lykhodid O. Pathophysiological substantiation of the improvement ways for pyelonephritis diagnosis

The thesis is devoted to pathogenetic substantiation of improving diagnosis of acute and chronic pyelonephritis. The clinical features of acute and chronic pyelonephritis in active and inactive phase of the disease have been studied. The data obtained have been compared with laboratory, functional and instrumental studies of kidneys. The data allowed to conclude that the most important criterion for the development of kidney inflammation is the presence of urinary symptom. By clinical and pathogenetic analysis it was shown that the main diagnostic indicator of urinary syndrome is the presence and value of leukocyturia that is a manifestation of exudation stage with emigration during inflammation. In order to prove leukocyturia active character as a manifestation of emigration a new method of determining the subpopulation of urine using immune complex-peroxidase antyperoxidase has been developed. According to it was found that in healthy individuals the presence of CD38 and CD45 cells in the urine is less twice than in the blood, and constitutes 4 % & 8 %, respectively. It is shown that pyelonephritis, especially in acute exacerbation of chronic, urine twice rising their rates. Active leukocyte CD38 and CD45 increase twice in number at acute and chronic pyelonephrities, while their change in blood is not reliable. It has been proved that the determination of the white blood cells subpopulation including CD38 and CD45, is a promising method of renal inflammation diagnosis and its phase development and can be used to monitor kidney diseases of inflammatory genesis.