Tsymbal V. Optimization of diagnostics and prognosis of diabetic nephropathy in children by studying the markers of kidney damage

The dissertation is devoted to issues of early diagnostics and prediction of diabetic nephropathy in children with diabetes mellitus by studying renospecific enzymes, vitamin D, connective tissue metabolism and ultrasound morphometric renal parameters. Increased excretion of renospecific enzymes in patients with diabetes mellitus has been determined, indicating a damage of glomerular and tubular apparatus during the first years of the disease. The analysis of morphometric parameters of the kidneys detected that with increasing duration of diabetes, there is a unidirectional remodelling of the kidneys of disproportionate type. Deep disorders of connective tissue metabolism have been detected in the examined children. Specific patterns of disorganization of connective tissue have been scientifically proved. Significantly lower levels of vitamin D in children with duration of diabetes over 5 years have been detected. Increased levels of vitamin D and VDBP excretion in urine of children with diabetes mellitus have been found. Additional diagnostic and prognostic markers of the formation of diabetic nephropathy with a high level of sensitivity and specificity are suggested.