perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2023-68-3-99-106perinatology-1832Research ArticleОБМЕН ОПЫТОМSHARING EXPERIENCESРебенок с впервые выявленным заболеванием почек и его семья: определение факторов прогрессирования болезни и особенности нефропротекцииA child with newly diagnosed kidney disease and his family: determination of early factors of disease progression and features of nephroprotectionhttps://orcid.org/0000-0003-3934-8699МаковецкаяГ. А.MakovetskayaG. A.

Маковецкая Галина Андреевна - д.м.н., проф. кафедры госпитальной педиатрии

443099 Самара, ул. Чапаевская, д. 89

Samara

https://orcid.org/0000-0002-3131-1368ПорецковаГ. Ю.PoretskovaG. Yu.

Порецкова Галина Юрьевна - д.м.н., доц., зав. кафедрой факультетской педиатрии

443099 Самара, ул. Чапаевская, д. 89

Samara

vra4_pediatr@mail.ruhttps://orcid.org/0000-0002-4373-0703МазурЛ. И.MazurL. I.

Мазур Лилия Ильинична - д.м.н., проф., зав. кафедрой госпитальной педиатрии

443099 Самара, ул. Чапаевская, д. 89

Samara

https://orcid.org/0000-0003-2864-6885СедашкинаО. А.SedashkinaO. A.

Седашкина Ольга Александровна - к.м.н., асс. кафедры факультетской педиатрии

443099 Самара, ул. Чапаевская, д. 89

Samara

https://orcid.org/0009-0005-5032-2846БариновВ. Н.BarinovV. N.

Баринов Виктор Николаевич - к.м.н., зав. отделением детской нефрологии

443095 Самара, ул. Ташкентская, д. 159

Samara

https://orcid.org/0000-0003-3459-5068РешетоваС. Н.ReshetovaS. N.

Решетова Светлана Николаевна - асп. кафедры госпитальной педиатрии

443099 Самара, ул. Чапаевская, д. 89

Samara

ФГОБУ ВО «Самарский государственный медицинский университет» Минздрава РоссииРоссияSamara State Medical UniversityRussian FederationГБУЗ СО «Самарская областная клиническая больница им. В.Д. Середавина»РоссияSeredavin Samara Regional Clinical HospitalRussian Federation20231507202368399106Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20232023Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1832

Хроническая болезнь почек и замедление ее прогрессирования составляют глобальную проблему здравоохранения. Однако факторы риска, связанные с первичной нозологией заболеваний клубочков у детей, недостаточно изучены.Цель исследования. На основе анализа клинико-анамнестических данных, особенностей проявления первично развившейся гломерулярной патологии и с учетом нозологических форм определить ранние факторы риска прогрессирования хронической болезни почек для более эффективной профилактики хронизации процесса.Материалы и методы. Обобщен опыт собственных клинических ретро- и проспективных наблюдений по формированию хронической болезни почек у детей с гломерулярной патологией. Исследование проводилось на базе детского уронефрологического центра Самарской областной клинической больницы им. В.Д. Середавина.Результаты. Систематизированы универсальные факторы риска: перенесенные критические состояния в перинатальном периоде с развитием острого повреждения почек; пренатально установленный CAKUT-синдром; наличие генетической предрасположенности к заболеваниям почек, комплекса аллергических заболеваний в семье; носительство персистирующих инфекций, гемолитических штаммов стрептококка, социальная детерминанта, экологические условия и др. Определены специфические ранние факторы риска развития заболевания, особенности дебюта патологии почек и биомаркеры прогрессирования, определяющие раннее повреждение почек. Сформулированы особенности нефропротекции: междисциплинарность в обучении с включением организационных, социальных компонентов; оперативная коммуникация с амбулаторным звеном; использование социальных сетей для образовательных процессов — семья пациента, обучение врачей первого контакта.

Chronic kidney disease and a decrease in its progression is a global health problem. However, the risk factors associated with the primary nosology of glomerular diseases of children have not been sufficiently studied.Purpose. To determine early risk factors for the progression of chronic kidney disease for more effective prevention of chronization of the process, based on the analysis of clinical and anamnestic data, the features of the manifestation of the primary developed glomerular pathology, and taking into account nosological forms.Material and methods. The experience of own clinical observations, retro- and prospective, related to the formation of chronic kidney disease of children with glomerular pathology is summarized. The study was conducted on the basis of the children’s uronephrological center of the Samara Regional Clinical Hospital named after V.D. Seredavin.Results. The universal risk factors are systematized: transferred critical conditions in the perinatal period with the development of acute kidney injury; prenatally established CAKUT syndrome; the presence of a genetic predisposition to kidney diseases, a complex of allergic diseases in the family; the carriage of persistent infections, hemolytic strains of streptococcus, social determinant, environmental conditions, etc. Specific early risk factors for disease progression, features of the onset of kidney pathology and biomarkers of progression that determine early kidney damage have been identified. The features of nephroprotection are formulated: interdisciplinarity with the inclusion of organizational, social components; operational communication with the outpatient link; the use of social networks for educational processes — the patient’s family, training of first-contact doctors.

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The authors declare that there are no conflicts of interest present.