Clinical and anamnestic characteristic of children with vesicoureteric reflux and reflux nephropathy
THE AIM OF THE STUDY was to establish clinical, paraclinical, anamnestic characteristics of different stages of tubulointerstitial damage of kidneys in children. PATIENTS AND METHODS. Complex medical examination of anamnestic, clinical, paraclinical data of 188 children aged 1 year to 17 years was done. Patients were divided in groups: with reflux nephropathy (n = 118), VUR (n = 40) and control (n = 30). RESULTS. Analysis of medical and biological anamnesis of patients with reflux nephropathy and VUR showed that perinatal pathology were significantly more frequent in patients with reflux nephropathy (74,6%, n = 88 ) compared with children with VUR (42,5%, n = 17 ), p < 0.001. Clinical features reflux nephropathy from patients with VUR were presence of syndrome of hypertension (86,4%, n = 102), renal infections (88,1%, n = 104), which are absent in patients with VUR (n = 0 ), p <0,001. Patients with reflux nephropathy had urinary syndrome with leukocyturia ( 88, 1 %, n = 104), proteinuria (100 %, n = 118 ), microhematuria (75,4%, n = 89). Absence of leukocyturia, proteinuria, microalbuminuria differed children with VUR from patients with reflux nephropathy (p < 0.001). Progression of tubulointerstitial renal damage occurs gradual increase in level of proteinuria, microalbuminuria. CONCLUSION. We established high frequency of perinatal factors which are risk factors for initiation of reflux nephropathy in children. Clinical differences of tubulointerstitial damage from VUR without of nephrosclerosis are presence of hypertension and renal infection. Progression of tubulointerstitial damage occurs gradual increase in the frequency of hypertension, in level of 24h proteinuria, including microalbuminuria and a phased reduction in frequency of renal infection.