Age characteristics of development and clinical manifestations of nephrotic syndrome in children in andijan region

ANNOTATION
TOPIC: "AGE CHARACTERISTICS OF DEVELOPMENT AND CLINICAL MANIFESTATIONS OF NEPHROTIC SYNDROME IN CHILDREN IN ANDIJAN REGION"

Relevance of the topic. Nephrotic syndrome (NS) in children continues to be an urgent clinical problem, despite the fact that the diagnostic criteria for NS are clearly defined, approaches to the treatment of various nephropathies with NS have been tested by many years of clinical practice and have been repeatedly published in various guidelines, including the Clinical Guidelines of the Union of Pediatricians of Russia [ one]. At the same time, the relevance of the problem of NS is determined by the fact that it can be based on a variety of nephropathies that require a differentiated approach to the management of such patients [2]. In addition, the dangers of NS are not exhausted by the possibility of progression of nephropathy to terminal chronic renal failure (ESRD), but are associated with a large loss of protein. As a result, the prognosis of NS is almost 100% determined by the effectiveness or ineffectiveness of immunosuppressive therapy, and before the use of glucocorticoids (GCS), lethality in NS was extremely high [3, 4].

The clinical and laboratory symptom complex of nephrotic syndrome is characterized by proteinuria with diagnostic significance in children of 1 g / m2 'day or 40 mg / m2 'h, hypoalbuminemia <25 g / l, hyperlipoproteinemia Pa and b, less often IV types, lipiduria, varying degrees, peripheral edema , cavitary, reaching the anasarca [3, 7, 9, 10, 34]. Important and completely unresolved is the problem of nephrotic syndrome diagnosed in children of the first year of life (0.5-2.5%).
Children with newly developed NS are hospitalized, as a rule, not in specialized nephrological centers, where it is possible to conduct morphobioptic, immunological, genetic and other high-tech studies, but in therapeutic departments of multidisciplinary hospitals. Therefore, the task of timely identification of those categories of patients who need a more in-depth examination and specialized high-tech assistance is relevant. In particular, the ineffectiveness of the standard course of corticosteroids in the debut requires a solution to the question of the possibility of immunosuppressive therapy in principle. In the relapsing course of hormone-sensitive NS, the main problem is frequent relapses, which entail the need for long-term immunosuppressive therapy, when the prognosis is largely determined by the side effects of treatment.

Purpose of the study: To determine the age of children with nephrotic syndrome and the characteristics of clinical and laboratory manifestations.

Research objectives:
1. Identify children with NS and distribute them by age.
2. To characterize the clinical symptoms of NS in children of different ages.
3. Determine the factors contributing to the development of NS in different age periods.
4. Conduct laboratory parallels among children with NS in different age groups.
Material and methods of research: 100 children will be examined in the Department of Nephrology of the ODMMC of Andijan city, aged 0 to 18 years, with nephrotic syndrome. All examined patients will undergo the following examinations:
1. Collection of anamnesis. Objective examination of children with NS
2. Separate children with NS into different age groups.
3. Conduct a comparative analysis of clinical and laboratory studies among children with NS.
Scientific novelty of the research
The age characteristics of children with nephrotic syndrome and the features of clinical and laboratory manifestations of NS will be proposed, which will make it possible to predict the outcomes of NS and determine ways to optimize treatment, taking into account possible morphological options.

PRACTICAL SIGNIFICANCE:

Taking into account the results of clinical and instrumental studies of children with nephrotic syndrome, based on the assessment of anamnestic data, the severity of the acute clinical picture, as well as laboratory and clinical indicators, the expediency of complex treatment of patients with NS, which helps to reduce the risk of chronicity and deaths, will be substantiated.