Pathogenetic Role of Endogenic Intoxication Indicators in Chronic Tubulointerstitial Ephritis in Children

Abstract

Despite the advances achieved in the diagnosis and treatment of nephropathies, almost 25% of patients continue to progress, which leads to a change in the quality of life.

        Purpose of the study. To reveal the pathogenetic role of molecules of kidney damage and tubular dysfunctions in chronic tubulointerstitial nephritis (CTIN) in children, taking into account the form of the disease.

         Research material. Depending on the clinical form of renal pathology, all patients were divided into 2 groups: group 1 - 52 (43%) children with recurrent CTIN (rCTIN) and group 2 - 68 (57%) patients with latent CTIN (lCTIN).

        Results. It should be noted that patients with rCTIN showed more significant shifts in the osmotic concentration of urine, glomerular filtration rate (GFR), proteinuria, urea, creatinine in the blood and urine than in children with lCTIN, where relatively pronounced hematuria was noted, which confirms the leading role aseptic inflammatory process in the change of tubulointerstitial tissue with impaired re nal function, including glomerular.

        Conclusions. In patients with rCTIN, in the acute stage, there are more pronounced disorders of the functional state of the kidneys (decreased GFR, urine osmolarity, daily urine output), while the severity of these disorders depends on the form and degree of activity of the pathological process. In patients with rCTIN, more pronounced changes in endogenous intoxication (EI) indices are noted, which are reflected in a decrease in the total concentration of albumin (ТCA), the effective concentration of albumin (ECA), the binding capacity of albumin (ВCA) and a stable increase in the toxicity index (IT), as well as in the increase of molecules of kidney damage (MPP) and ТСA in urine, which determines the importance of this diagnosticum.