For the last 20 years obesity and overweight in childhood have become one of the most important healthcare problems for the vast majority of countries, including Russia. There is a data that obesity in early age correlates with the risk factors of chronic diseases in adultness, including diabetes, cardio-vascular diseases, arterial hypertension and many others. That is why the main goal of our survey was to compare clinical-laboratory parameters and lab based indicators and to explore the details of arterial blood pressure indicators of pre-school and younger school children with and without obesity in one region of Russia (Lipetsk Region). We have analyzed those parameters in 2 groups of children: first group consisted of 50 children with obesity, and second 50 children with normal body mass. For checking the differences between two groups we have used Students t-test or its counterpart for independent samples MannWhitney U-test in cases when the variances of the values were high. The results of survey have shown the high index of hereditary burden among children with obesity, more birth weight of those ones, higher levels of glucose, cholesterol, and low density triglicerids andindex atherogenicity. The measurements of arterial blood pressure (systolic and diastolic) three times per day every day during a week showed significant increasing from mornings to evenings and from the beginning to the end of the week. The highest number of significant coefficients of correlation has been revealed between body mass of the children with obesity and arterial blood pressure (systolic and diastolic) during the day.
Timely diagnosis of acute kidney injury (AKI) is a multidisciplinary problem and a topic of numerous scientific studies. Diabetic ketoacidosis (DKA) is one of the medical emergencies for which diagnosis of AKI becomes of potentially high importance. This literature review provides data on the incidence of AKI, associated factors and disease-specific health outcomes in children with DKA in type 1 diabetes mellitus. Scientific articles were searched for in the eLIBRARY and PubMed databases. The inclusion criteria were met by 6 original scientific studies, based on the results of which it was concluded that AKI is a common condition in DKA, and the problem of its timely diagnosis requires increased attention of clinicians.
BACKGROUND: Overweight and obesity in children are one of the most serious problems of the modern world. There are mane publications devoted to kidney injury in patients with obesity. This injury in developed imperceptibly, without clinical symptoms. Probably the diagnostics of kidney injury in children with obesity may be improved by studying new urinary markers: KIM-1, NGAL, IL-18, 2-mg. AIM: Aim of our study was the comparative analysis of urinary markers of tubular kidney injury (KIM-1, NGAL, IL-18, 2-mg) in children with obesity and kidney diseases. MATERIALS AND METHODS: We have been studied 78 children aged 715 years: 40 children with different kidney diseases and 38 patients with obesity and kidney diseases. The results of the study were presented as markers concentration in urine and as relation to creatinine (normalized indicators). RESULTS: In children with obesity and kidney diseases the level of KIM-1 was more high in comparison with the children without obesity. The concentration of other markers (NGAL, IL-18, 2-mg) did not differ in children of two groups. The same results were received when analyzing normalized indicators. It was appeared significant correlation between body mass of patients and NGAL of urine in both groups. CONCLUSIONS: Investigation of urinary KIM-1 have significance for diagnostics of tubular kidney injury in children with obesity on the background of kidney diseases. Established significant correlation NGAL with body mass can testify about it is diagnostic significance for obesity regardless of kidney diseases.
named after N.N. Burdenko, 2 regional children's clinical hospital № 1, Voronezh, Russia РЕФЕРАТ ЦЕЛЬ. Оценка частоты и течения острого повреждения почек (ОПП) у детей на различных этапах терапии лейкозов. ПАЦИЕНТЫ И МЕТОДЫ. В исследование было включено 143 ребенка с различными вариантами лейкоза, получавшими лечение на базе онкогематологического отделения химиотерапии Воронежской областной детской клинической больницы №1 за период с 01.2008г. по 01.2014г. Наблюдение проводилось на 4-х этапах: до назначения полихимиотерапии (ПХТ), на этапе интенсивной ПХТ, в период поддерживающей ПХТ и на этапе после окончания лечения в периоде стойкой ремиссии. ОПП диагностировали с учетом уровня скорости клубочковой фильтрации (СКФ) и креатинина сыворотки крови, превышающих нормальные значения как минимум в 1,5 раза (на 25%). РЕЗУЛЬТАТЫ. ОПП диагностировано у 109 детей (76,2%) из 143 обследованных, причем стадия риска ОПП (Risk) выявлена у 44 детей (30,8%), стадия повреждения (Injury)-у 46 детей (32,2%), стадия недостаточности (Failure)-у 19 детей (13,3%). ОПП отмечалось на всех этапах терапии, но максимально часто (у 77 из 89 детей, 86,5%)-на этапе интенсивного лечения. У 16 из 30 детей (53,3%), наблюдавшихся на всех этапах терапии, ОПП различных стадий регистрировалось неоднократно, максимально до 4 раз. За период наблюдения летальный исход наблюдался у 20 пациентов, в основном в периоде интенсивной ПХТ, у всех было ОПП средней и тяжелой степени тяжести: 8-стадия Injury, 12-стадия Failure. ЗАКЛЮ-ЧЕНИЕ. ОПП достаточно часто регистрируется у детей с лейкозами, максимально часто на этапе интенсивной ПХТ. Развитие ОПП ухудшает прогноз лейкоза у детей в отношении выживаемости. У одного и того же пациента возможно неоднократное развитие ОПП на разных этапах лечения. Ключевые слова: острое повреждение почек, лейкозы, дети. ABSTRACT THE AIM. Evaluation of frequency and course of acute kidney injury (AKI) in children with leukemia at the different stages of therapy. PATIENTS AND METHODS. In our study we included 143 children with different variants of leukemia receiving polychemiotherapy (PCHT) at oncohematolological unit of VRCH №1 for the period from 01.2008 to 01.2014 year. The observation was conducted at 4 stages: before polychemiotherapy (PCHT), during intensive PCHT, during maintaining PCHT, after the end of the treatment during stable remission. AKI was diagnosed with regard to the level of glomerular filtration rate (GFR) and serum creatinine which were decreased and increased respectively minimum in 1.5 times (25%). RESULTS: We diagnosed AKI in 109 children (76,2 %) from 143 observed patients, Risk stage was found in 44 children (30,8 %), the stage of Injury-in 46 children (32,2 %), the stage of Failure-in 19 children (13,3%). AKI was noted at all phases of chemotherapy, maximum at the stage of intensive PCHT (in 77 from 89 children, 86,5 %). In 16 from 30 children (53,3 %) observed during all phases of treatment AKI registered several times (maximum 4 times). During the period of observation the fatal outcome was registrate...
THE AIM: to compare the parameters of physical development (PD) in children with idiopathic nephrotic syndrome (INS), depending on the treatment with prednisone.PATIENTS AND METHODS. The effect of treatment with prednisone on PD was analyzed in 60 children with INS aged from 2 to 17 years. The children were divided into 2 groups: 30 children who did not receive prednisone, and 30 children who received it during the last 6 months before the study (1st and 2nd group, respectively). The groups compared the anamnestic parameters and the risk factors of children in terms of length, weight, and body mass index.RESULTS. When comparing the characteristics of the risk factors of children of the above 2 groups, differences in body mass and BMI were established. In children who received prednisone for the last 6 months, body weight and BMI were significantly exceeded compared to WHO standards and similar patients who did not receive prednisone for the last 6 months. We have established a reliable association of the Z-BMI criterion with the cumulative dose of prednisone in the last 6 months: r = 0.49, p <0.05. At the same time, no reliable association of body weight with a cumulative dose of prednisone, which the child received before 6 months, has been identified. When analyzing the effectiveness of different doses of prednisone therapy for stopping relapses in children with steroid-sensitive INS, it was found that the onset and duration of remission did not significantly differ when taking standard (60mg/m2/day or 2 mg/kg/day) and half as much (1mg/kg/day) doses of prednisone.CONCLUSION. The relationship of the body mass of children with INS and the cumulative dose of prednisone in the last 6 months has been established. When treating a recurrent steroid-sensitive non-relapsing INS, a decrease in the daily dose of prednisone from 2 mg/kg/day to 1 mg/kg/day is possible in adolescents who are afraid of steroid obesity or who have had severe complications during previous courses of prednisone therapy.
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