Pidval'na N. Diagnostic and prognostic significance of tubular and glomerular damage markers in children with a solitary kidney

This thesis is devoted to improve ment of early diagnostics and prediction of chronic kidney disease progression in children with a solitary kidney of different origin. The functional status of a solitary kidney in children was determined. In the overwhelming majority of the patients nosological forms of the solitary kidney pathology underlying the CKD formation and progression were diagnosed. It was shown that a significant increase of urinary excretion levels of alkaline phosphatase, gamma-glutamyltransferase, succinate dehydrogenase, cholinesterase is the marker of tubular and glomerular damage. It was found that solitary kidney remodeling depends on the glomerular filtration rate (GFR) and happens according to proportional or disproportional type. It was proved that the index of solitary kidney parenchyma volume the is most informative parameter for predicting of the GFR level. The types of renal hemodynamic disorders in patients with a solitary kidney were determined. The associations between types of renal hemodynamic disorders and the renal function state were identified. The high level of discrimination of connective tissue metabolites levels in children with a solitary kidney of different origin was determined that allowed to differentiate varions patterns of connective tissue disorganization. The algorithm for prediction of chronic kidney disease progression in children with a solitary kidney was proposed.