ECHOGRAPHIC CRITERIONS OF MECHANISMS OF CHRONIC RENAL DISEASE PROGRESSING IN CHILDREN

Inhibition of renal functional activity in children happens at an early age in proportion to stage of obstructive uropathy and activity of inflammation. Echographic and doppler scanning meet clinical and pathogenetic stages of development of chronic obstructive pyelonephritis. On Doppler sonography renal arterial blood flow velocity increase significantly along the whole length of renal blood stream in children on active stage of chronic pyelonephritis (p<0,05). Maximum systolic velocity in comparison with ultimate diastolic velocity increases in a greater degree. It determines elevation of peripheric resistance. At zero interstitial inflammation and low-grade obstructive uropathy, there has been mean value of resistance index (0,64+-0,03). It characterizes appropriate vascular tone. On B-scan sonography of patients with arteriolosclerotic kidney, renal reduction, irregular margins of renal, absence of cortico-medullary differentiation, diffuse irregular change of renal parenchyma with heterogenic hyperechogenicity, medium dilatation of renal collecting system are diagnosed significantly (p<0,001). On Doppler sonography for stage of decompensation there has been marked decline of blood flow velocity at all levels of renal blood stream, for some cases — absence of parenchyma blood circulation.

Main role of development of chronic obstructive pyelonephritis in children belongs to renal blood failure. Their degree detects clinical and pathogenetic stages of disease. At the compensated stage blood flow velocity increase in proportion to activity of inflammation. Subcompensated stage is characterized vasospasm. Hypoperfusion is principal rate for stage of decompensation. Criterions of prediction of outcomes of chronic renal disease are change of thickness of renal parenchyma, maximum systolic velocity and ultimate diastolic velocity, resistance index. Pathogenetic mechanism of staging of renal circulatory failure is basis for principles research on renal dysfunction.

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