Биология ва тиббиёт муаммолари, 2015, №3 (84) 75
UDK: 616.61-002.053
ENDOGENOUS INTOXICATION IN CHILDREN WITH CHRONIC PYELONEPHRITIS
N.I. AKHMEDJANOVA, F.M. HAMIDOVA, R.R. MURADOVA, R.M. NURALIYEVA,
Sh.I. TUXTANAZAROVA
Samarkand State Medical Institute, Republic of Uzbekistan, Samarkand
СУРУНКАЛИ ПИЕЛОНЕФРИТ БЎЛГАН БОЛАЛАРДА ЭНДОГЕН ИНТОКСИКАЦИЯ
Н.И. АХМЕДЖАНОВА, Ф.М. ХАМИДОВА, Р.Р. МУРАДОВА, Р.М. НУРАЛИЕВА,
Ш.И. ТУХТАНАЗАРОВА
Самарқанд Давлат медицина институти, Ўзбекистон Республикаси, Самарқанд
ЭНДОГЕННАЯ ИНТОКСИКАЦИЯ У ДЕТЕЙ С ХРОНИЧЕСКИМ ПИЕЛОНЕФРИТОМ
Н.И. АХМЕДЖАНОВА, Ф.М. ХАМИДОВА, Р.Р. МУРАДОВА, Р.М. НУРАЛИЕВА,
Ш.И. ТУХТАНАЗАРОВА
Самаркандский Государственный медицинский институт, Республика Узбекистан, г. Самарканд
Дисметаболитик нефропатия (ДН) ва унинг муҳитида ривожланадиган болалар сурункали
пиелонефритини ўрганиш педиатрия ва болалар нефрологиясида долзарб ҳисобланади. Ишнинг
мақсади: Эндоген интоксикацияни (ЭИ) диагностик информацион комплексини аниклаш 4 ёшдан 14
ёшгача бўлган 55 нафар болалар ўрганиб чиқилди, шулардан 30 нафари соғлом ва 25 нафари ДН
муҳитида ривожланган оксалатли-кальцийли кристаллуриянинг авж олиши билан. Текширувлар
натижасида буйраклар функционал кўрсаткичларининг пасайиши, яъни: оксалурининг кўпайиши,
шунинг билан бирга умумий альбуминнинг пасайиши ва ўртача ўлчамли молекулалар, С-РБ
даражасининг кўпайиши аниқланди.
Калит сўзлар:
иккиламчи сурункали пиелонефрит, эндоген интоксикация, ўртача ўлчамли
молекулалар, албумин.
Dysmetabolic nephropathy (DM) and matured on its phone secondary pyelonephritis in children are
highly actual in Pediatrics and children nephrology. The aim of the work: To identify diagnostic informative
complex of indication Endogenous intoxication (EI). It were examined 55 children in age from 4 till 14
years, 30 absolute healthy and 25 with Chronic Pyelonephritis on the phone of Dysmetabolic Nephropathy
with oxalate-calcium crystallluria in the stage exacerbation disease. It was established reliable decreasing of
indications kidney function, and increasing oxaluria, and also reducing general albumin and increasing the
level of medium molecul, M-RP. Assessment results of research in functional state of kidneys and the medi-
um level of molecul in blood plasm in children with Chronic Pyelonephritis showed diagnostical significance
to identify MM, as diagnostic method of EI.
Key words:
secondary chronic pyelonephritis, endogenous intoxication, medium molecules, albumin.
Introduction.
In patients with secondary
pyelonephritis saved highly risk of development
chronic kidney disease (Chr.KD) with formal chron-
ic renal failure (Chr.RF) and decreasing the quality
of life already in childhood. [1,5]. The most com-
mon dysmetabolic nephropathy in the structure is
oxalate crystalluria, which fall on 68-71%, 15% fall
on lithate [3,4].
Under DN increase a large group of
nephropathy with variety etiology and pathogenesis,
developing in consequence disturbances of metabo-
lism. The problem of dysmetabolic nephropathy
(DN) and developed on their phone secondary pye-
lonephritis in children are greatly actual in Pediat-
rics and children nephrology [3,4,5]. Pathology of
exchange leads to changing functional state of kid-
neys (FSK) or to structural displacement on differ-
ent level of nephron elements.
From the beginning of birth age DN pro-
gress right of way till child development in children
with urinestone disease, interstitial nephritis, chron-
ic pyelonephritis (Chr.P), renal failure [26].
Stratification microbe-inflammation process
in children with DN as a rule leads to impairment
filtration of kidney function [3,5].
Endogenous intoxication (EI) is a Polyetio-
logical Syndrom, characterized accumulation of tis-
sues and biological fluids of endogenous intoxica-
tion substance, represent their excess products nor-
mal and perversely metabolism or cellular reaction.
This is difficult polyorganic pathological state, in-
cluding disturbances mechanisms transporting toxic
substance in organs, their transformation and excre-
tion, disturbances of biotransform toxins ability [1].
The markers of EI are the level of medium molecul
(MM), albumins, medium-reactive protein (MRP).
Accumulation of MM maintain current of patholog-
ical process, acquire role of secondary toxins, which
influence on vital activity in all systems and organs
[7].
Endogenous intoxication in children with chronic pyelonephritis
76 Проблемы биологии и медицины, 2015, №3 (84)
Set of problem.
The aim of the work: To
determine diagnostic informative complex of indica-
tors EI in children with chronic pyelonephritis on
the phone of metabolic disturbances.
Materials and methods of research: 55 chil-
dren were examined at the ages of 4-14, 30 abso-
lutely healthy, 25 - with Chr.P. on the phone of DN
in children with oxalate-calcium crystalluria in the
stage of exacerbation.
Glomerular filtration of kidney s detected on
clearance endogenous creatinin (Van Slayke), creat-
inin in blood and urine – on summarily containing
chromogens, based on reaction JFFE (E.D. Ponoma-
rova with authors. 1969).
Osmolarity of urine determined in algoscop-
ic method on apparatus OMK-1, TH-01. A numeral
identification oxalates in urine carried out on
N.V.Dmitrevoy. (1996). Daily amount of excretion
oxalates carried out in the following formulas:
Amount
of
permanganate
potassium
(KMg04)x0,63)-0,1xD/2=mg daily oxalate, where:
0,63-permanent coefficient; D-diuresis.
Identification of molecul medium mass car-
ried out on the method of I.I. Jadenova (2002y), M-
RP on the method of latex immunonephelometry in
analizator BN-ProSpec; total protein in the blood
determined azometerical: accoding to the classical
method of Keldalya (1883) and his modifications;
total albumin measured in fluorescental method by
(Miller Yu.A.,Dobresov G.E.1992).
Mathematical manipulation of receiving
results carried out with the help of computer in sta-
tistic Programm Excel.
Results.
External clinic sign of EI in chil-
dren with Chr.P. on the phone of DN with oxalate-
calcium crystalluria (includes general fatigue, loss
of appetite, somnolence, sleep disorders, pain in the
area of lumbar) were not permanent and poor ex-
pressed.
Sufficient informative in diagnostic plan
showed indications in practical function of kidney.
It was established reliable decreasing RGF (the rate
of glomerular filtration) (P<0,05) (table)., in sick
children with the comparisons healthy one.
Notes: R-reliability differences between in-
dications of healthy and chronic pyelonephritis in
children.
Urine Osmolarity was statistical reliable re-
ducing (P<0,001). Oxaluria in average consists of
42,9+2,67 mg/daily, that was reliable higher than
healthy one (P<0,001).
During investigation the indication of EI de-
tected increasing the level of MM in children with
Chr.P. till treatment 0,270+0,004 average conven-
tional units in norm 0,135+0,001 conventional units
in healthy one. It was establishment reliable
(P<0,001) reducing contain of total albumin plasm
of blood till 31+3,3g/l in sick children with Chr.P.
The level of M-RP under consideration is
the most sensitive laboratory marker infections, in-
flammation and tissue damage, was reliable in-
creased till 16+4,4 mg/l in blood plasm of children
with Chr.P. in comparisons with the indications of
healthy children. (P<0,001). Detected disorders al-
lowed to make conclusions.
Table
The indications of kidney function and Endogenous Intoxication in children with Chronic Pyelonephritis.
(M+m)
Indications
Healthy children (n=30)
Chr.P (n=25)
I.
Kidney function:
RGF, ml/min.m2
98,6+7,8
69,11+1,16
P<0,05
Urine Osmolarity, mosm/l
1000+200
610,46+20,05
P<0,001
Daily dieresis, l/daily
1,7+0,036
1,06+0,028
P<0,001
Ocsaluria, mg/daily
25+2,4
42,9+2,67
P<0,001
II.
Endogenous intoxication:
Protein of plasm, g/l
68,4+4,1
57+3,2
P<0,001
Total albumin of plasm, g/l
40,2+2,1
31+3,3
P<0,001
Medium moleculas conventional
units
0,135+0,001
0,270+0,004
P<0,001
M-reactive protein mg/l
5+4,1
16+4,4
P<0,001
N.I. Akhmedjanova, F.M. Hamidova, R.R. Muradova, R.M. Nuraliyeva, Sh.I. Tuxtanazarova
Биология ва тиббиёт муаммолари, 2015, №3 (84) 77
Conclusions:
1.
In the period exacerbation of Chr.P. is marked
reducing MGF, urine osmolarity and increasing ox-
aluria.
2.
During the exacerbation of Chr.P. in children the
indication of EI characterized significant reducing
of total albumin of blood plasm and increasing the
level of MM and M-RP in blood plasm.
Received results improve diagnostic significant of
research indications of EI, that permit to advice its,
including for estimation detoxication procedures.
References:
1.
Aksenova V.M., Starkova A.V. Biochemical di-
agnostic
method
of
Endogenous
Intoxica-
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Albitskiy V.Yu. Regional particularity of healthy
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3.
Baranov A.A. Progress and perspective devel-
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Dlin
V.V.
Dysmetabolic
Nephropathy,
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ЭНДОГЕННАЯ ИНТОКСИКАЦИЯ У ДЕТЕЙ
С ХРОНИЧЕСКИМ ПИЕЛОНЕФРИТОМ
Н.И. АХМЕДЖАНОВА, Ф.М. ХАМИДОВА,
Р.Р. МУРАДОВА, Р.М. НУРАЛИЕВА,
Ш.И. ТУХТАНАЗАРОВА
Самаркандский Государственный медицинский
институт, Республика Узбекистан, г. Самарканд
Дисметаболическая нефропатия (ДН) и
развившийся на её фоне вторичный пиелонефрит
у детей является весьма актуальной в педиатрии
и детской нефрологии. Цель работы: определе-
ние диагностически информативного комплекса
показателей эндогенной интоксикации (ЭИ). Об-
следовано 55 детей в возрасте от 4 до 14 лет, 30
практически здоровых и 25 с ХП на фоне ДН с
оксалатно-кальциевой кристаллурией в стадии
обострения заболевания. Установлено достовер-
ное снижение показателей функции почек, по-
вышение оксалурии, а также снижение общего
альбумина и повышение уровня средних моле-
кул, С-РБ. Оценка результатов исследования
функционального состояния почек и уровня
средних молекул в плазме крови у больных ХП
показала диагностическую значимость опреде-
ления СМ, как метода диагностики ЭИ.
Ключевые
слова:
вторичный
хронический
пиелонефрит,
эндогенная
интоксикация, средние молекулы, альбумин.
