Тhe сlinical and мorphological сharacteristics оf nephropathy first manifested with isolated hematuria
Background. Nephropathy associated with hematuria progress represent the greatest differential diagnostic difficulties because of the similarity of clinical manifestations, especially at the early stages of the disease, which tend to prolonged and chronic course and, in some cases, lead to chronic renal failure. A differential approach to the diagnosis of these diseases is important for the choice of therapy in this group of children. The main method for differential diagnosis of nephropathy is to conduct morphological study of the kidney tissue in vivo. The purpose was to study the clinical manifestations of renal functional state and morphological features of nephropathy with hematuria syndrome in children to improve differential diagnosis of these diseases. Materials and methods. The study involved 158 children with kidney disease with hematuria deterioration, aged 1 to 18 years. The survey group included children observed for hematuria from micro to gross hematuria without extrarenal manifestations over a year. The level of hematuria, urine albuminuria, blood biochemical parameters, glomerular filtration rate, morphological changes of the kidney tissue according to kidney biopsy lifetime were studied. Results. Kidney biopsy carried out in terms from 1 year up to 3 years after the onset of the disease in children with clinically diagnosed glomerulonephritis, hematuria form, and hereditary nephritis, has revealed the heterogeneity of the morphological forms of nephropathy, with IgA nephropathy prevalence (48.4%), thin basement membrane disease (29 %), hereditary nephritis (Alport syndrome) (22.6%). Conclusion. Despite the similarity of clinical manifestations, especially at the early stages of the disease, it was identified a number of clinical-anamnestic and laboratory differences of these dise-ases, that underlines the need for a differentiated approach to the interpretation of the changes in the urine and diagnosis formulating in patients with isolated hematuria, determines the treatment tactics and further rehabilitation.
Full Text:PDF (Українська)
Borisova T.P. Clinical and morphological characteristics and efficacy of treatment of acute glomerulonephritis with nephritic syndrome in children. Sovremennaja pediatrija. 2010;1:185-9. (In Russian).
Kolesnyk MO, Nepomnyashhy VM, Romanenko AM, Zabarko LB, Tumarkina MV. Gіstologіchna klasifіkacіja, glosarіj ta morfologіchna harakteristika pervinnih glomeruljarnih zahvorjuvan': Metodichnі rekomendacії [The histological classification, a glossary, and morphological characteristics of primary glomerular diseases: guidelines]. Kyiv; 2003. 24 p. (In Ukrainian).
Batinić D, Sćukanec-Spoljar M, Milosević D, Nizić L, Vrljicak K, Matković M. Renal biopsy in children with isolated microhematuria. Acta Med Croatica. 2002;56(4-5):163-66. (In Croatian). PMID: 12768895.
Gutierrez E. Zamora I, Ballarín JA, Arce Y, Jimenez S, Quereda C, et al.; Grupo de Estudio de Enfermedades Glomerulares de la Sociedad Española de Nefrología (GLOSEN). Long-term outcomes of IgA nephropathy presenting with minimal or no proteinuria. J Am Soc Nephrol. 2012;23:1753-60. doi: 10.1681/ASN.2012010063.
Maisonneuve P, Agodoa L, Gellert R, Stewart JH, Buccianti G, Lowenfels AB, et al. Distribution of primary renal diseases leading to end-stage renal failure in the United States, Europe, and Australia/New Zealand: results from an international comparative study. Am J Kidney Dis. 2000;35:157-65. doi: 10.1016/S0272-6386(00)70316-7.
Polito MG, de Moura LA, Kirsztajn GM. An overview on frequency of renal biopsy diagnosis in Brazil: clinical and pathological patterns based on 9,617 native kidney biopsies. Nephrol Dial Transplant. 2010;25:490-6. doi: 10.1093/ndt/gfp355.
Copyright (c) 2017 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018