urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.1.70NKECUJurmj-1726Research ArticleОригинальные статьи | Original articlesOriginal articlesПроблема распространенности болезней почек у детей в контексте официальной статистики и специализированного приема нефрологаThe Problem of the Prevalence of Kidney Diseases in Children in the Context of Official Statistics and a Specialized Appointment with a Nephrologisthttps://orcid.org/0000-0002-7958-6360СафинаЕ. В.SafinaE. V.

Елена Валентиновна Сафина — ассистент кафедры детских болезней, институт педиатрии и репродуктивной медицины

Екатеринбург

Elena V. Safina — Assistant of the Department of Pediatric Diseases

Ekaterinburg

evsafina84@mail.ruhttps://orcid.org/0000-0002-6909-1487ПлотниковаИ. А.PlotnikovaI. A.

Инга Альбертовна Плотникова — доктор медицинских наук, доцент кафедры детских болезней, институт педиатрии и репродуктивной медицины

Екатеринбург

Inga A. Plotnikova — Doctor of Sciences (Medicine), Associate Professor of the Department of Pediatric Diseases

Ekaterinburg

inga63@bk.ruhttps://orcid.org/0000-0001-8897-6689ЗеленцоваВ. Л.ZelentsovaV. L.

Вера Леонидовна Зеленцова — доктор медицинских наук, профессор, заведующий кафедрой детских болезней, институт педиатрии и репродуктивной медицины

Екатеринбург

Vera L. Zelentsova — Doctor of Sciences (Medicine), Professor, Head of the Department of Pediatric Diseases

Ekaterinburg

vera-zelentsova@mail.ruhttps://orcid.org/0000-0002-3283-4582МышинскаяО. И.MyshinskayaO. I.

Ольга Ивановна Мышинская — кандидат медицинских наук, доцент кафедры детских болезней, институт педиатрии и репродуктивной медицины

Екатеринбург

Olga I. Myshinskaya — Candidate of Sciences (Medicine), Associate Professor of the Department of Pediatric Diseases

Ekaterinburg

meilaoshi@mail.ruhttps://orcid.org/0000-0001-8394-627XМалыхО. Л.MalykhO. L.

Ольга Леонидовна Малых — кандидат медицинских наук, ведущий научный сотрудник лаборатории социально-гигиенического мониторинга и управления рисками

Екатеринбург

Olga L. Malykh — Candidate of Sciences (Medicine), Leading Researcher of the Laboratory of Social and Hygienic Monitoring and Risk Management

Ekaterinburg

o.l.malykh@mail.ruУральский государственный медицинский университетРоссияUral State Medical UniversityRussian FederationЕкатеринбургский медицинский научный центр профилактики и охраны здоровья рабочих промпредприятийРоссияEkaterinburg Medical Scientific Center for Prevention and Health Protection of Industrial WorkersRussian Federation20250303202524170–82Copyright © Сафина Е.В., Плотникова И.А., Зеленцова В.Л., Мышинская О.И., Малых О.Л., 20252025Сафина Е.В., Плотникова И.А., Зеленцова В.Л., Мышинская О.И., Малых О.Л.Safina E.V., Plotnikova I.A., Zelentsova V.L., Myshinskaya O.I., Malykh O.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1726

Введение. Проблема хронической болезни почек (ХБП) у детей остается актуальной. Изучение структуры заболеваний почек важно для разработки превентивных мер.Цель исследования — провести анализ структуры патологии мочевыделительной системы детей на приеме нефролога в различные возрастные периоды, соотнести результаты с показателями по обращаемости за медицинской помощью и установленной инвалидности по заболеваниям почек у детей в России и субъектах Уральского федерального округа.Материалы и методы. Анализ заболеваемости детей по классу «Болезни мочеполовой системы», инвалидности детского населения России и Уральского федерального округа по материалам Росстата, статистических сборников «Здравоохранение в России», отчету нефролога Детской городской больницы № 8 (Екатеринбург).Результаты. Снижение первичной заболеваемости в группе «Гломерулярные, тубулоинтерстициальные болезни почек, другие болезни почки и мочеточника» идет вразрез с ростом впервые выявленной почечной недостаточности. 70 % первичных обращений к нефрологу обусловлено микробно-воспалительными заболеваниями, пик приходится на 5–9 лет, уродинамические и диспластические болезни преобладают в раннем возрасте.Обсуждение. Дебют нефроурологических заболеваний, ассоциированный с аномалиями развития, приводит к ХБП в 42,5 %. Наблюдаемый в России на 30,1 % рост случаев по классу «Врожденные аномалии, деформации и хромосомные нарушения» у детей первого года жизни, с удельным весом пороков мочевой системы 25–50 %, свидетельствует об увеличении последних, ухудшая прогноз нефроурологических заболеваний Выводы. Снижение показателей заболеваемости органов мочевой системы по данным официальной статистики не вполне отражает проблему формирования ХБП у детей. Возникает необходимость выделения периода раннего возраста и регистрации аномалий органов мочевой системы в формах официального статистического наблюдения.

Introduction. The problem of chronic kidney disease (CKD) in children is relevant. Studying the structure of kidney diseases is important for developing prevention.Purpose — To analyze the structure of pathology in children at a nephrologist’s appointment at different age periods, to provide a comparative assessment with the incidence rates and established disability due to kidney disease in children in Russia and in the subjects of the Ural Federal District.Materials and methods. Analysis of child morbidity in the class of “Diseases of the genitourinary system”, disability of the child population and report of a nephrologist of the Children’s City Hospital No. 8 (Ekaterinburg).Results. The decrease in the incidence in the group “Glomerular, tubulointerstitial kidney diseases, other kidney and ureter diseases” contradicts the growth of “Renal failure”. 70 % of visits to a nephrologist are due to microbial inflammatory diseases, with the peak at 5–9 years, at an early age urodynamic and dysplastic diseases predominate.Discussion. The nephrourological diseases associated with developmental anomalies leads to CKD in 42.5 %. In Russia 30.1 % congenital anomalies increased in children of the first year, with a proportion of urinary system defects of 25–50 %, indicates an increase their, worsening the prognosis of nephrourological diseases.Conclusions. The decrease of urinary system diseases, according to official statistics, doesn’t reflect the problem of CKD in children. We need to identify the period of early age and register urinary system anomalies in the forms of official statistical observation.

заболеваемостьпатология органов мочевой системыдетиинвалидностьврожденные пороки развитияmorbiditypathology of the urinary systemchildrendisabilitycongenital malformationsReferencesVyalkova AA, Gritsenko VA. Urinary tract infection in children: Current aspects of etiological diagnosis and treatment. Russian Bulletin of Perinatology and Pediatrics. 2017;62(1):99–108. (In Russ.). DOI: https://doi.org/10.21508/1027-4065-2017-62-1-99-108.Vyalkova AA, Gritsenko VA. Urinary tract infection in children: Current aspects of etiological diagnosis and treatment. Russian Bulletin of Perinatology and Pediatrics. 2017;62(1):99–108. (In Russ.). DOI: https://doi.org/10.21508/1027-4065-2017-62-1-99-108.Simões e Silva AC, Oliveira EA, Mak RH. Urinary tract infection in pediatrics: An overview. Jornal de Pediatria. 2020;96(S1):65–79. DOI: https://doi.org/10.1016/j.jped.2019.10.006.Simões e Silva AC, Oliveira EA, Mak RH. Urinary tract infection in pediatrics: An overview. Jornal de Pediatria. 2020;96(S1):65–79. DOI: https://doi.org/10.1016/j.jped.2019.10.006.Makovetskaya GA, Mazur LI, Kurshina MV, Рyrkova SA, Reshetova SN. Congenital anomalies of the kidneys and urinary tract in children — a topical problem of pediatrics. Practical Medicine. 2021;19(6):38–42. (In Russ.). DOI: https://doi.org/10.32000/2072-1757-2021-6-38-42.Makovetskaya GA, Mazur LI, Kurshina MV, Рyrkova SA, Reshetova SN. Congenital anomalies of the kidneys and urinary tract in children — a topical problem of pediatrics. Practical Medicine. 2021;19(6):38–42. (In Russ.). DOI: https://doi.org/10.32000/2072-1757-2021-6-38-42.Ishiwa S, Sato M, Morisada N, Nishi K, Kanamori T, Okutsu M, еt al. Association between the clinical presentation of congenital anomalies of the kidney and urinary tract (CAKUT) and gene mutations: An analysis of 66 patients at a single institution. Pediatric Nephrology. 2019;34(8):1457–1464. DOI: https://doi.org/10.1007/s00467-019-04230-w.Ishiwa S, Sato M, Morisada N, Nishi K, Kanamori T, Okutsu M, еt al. Association between the clinical presentation of congenital anomalies of the kidney and urinary tract (CAKUT) and gene mutations: An analysis of 66 patients at a single institution. Pediatric Nephrology. 2019;34(8):1457–1464. DOI: https://doi.org/10.1007/s00467-019-04230-w.Kutyrlo IE, Savenkova ND. CAKUT-syndrome in children. Nephrology. 2017;21(3):18–24. (In Russ.). DOI: https://doi.org/10.24884/1561-6274-2017-3-18-24.Kutyrlo IE, Savenkova ND. CAKUT-syndrome in children. Nephrology. 2017;21(3):18–24. (In Russ.). DOI: https://doi.org/10.24884/1561-6274-2017-3-18-24.Renko M, Salo J, Ekstrand M, Pokka T, Pieviläinen O, Uhari M, et al. Meta-analysis of the risk factors for urinary tract infection in children. The Pediatric Infectious Disease Journal. 2022;41(10):787–792. DOI: https://doi.org/10.1097/INF.0000000000003628.Renko M, Salo J, Ekstrand M, Pokka T, Pieviläinen O, Uhari M, et al. Meta-analysis of the risk factors for urinary tract infection in children. The Pediatric Infectious Disease Journal. 2022;41(10):787–792. DOI: https://doi.org/10.1097/INF.0000000000003628.Vyalkova AA, Zorin IV, Chesnokova SA, Plotnikova SV. Chronic kidney disease in children. Nephrology. 2019;23(5):29–46. (In Russ.). DOI: https://doi.org/10.24884/1561-6274-2019-23-5-29-46.Vyalkova AA, Zorin IV, Chesnokova SA, Plotnikova SV. Chronic kidney disease in children. Nephrology. 2019;23(5):29–46. (In Russ.). DOI: https://doi.org/10.24884/1561-6274-2019-23-5-29-46.Becherucci F, Roperto RM, Materassi M, Romagnani P. Chronic kidney disease in children. Clinical Kidney Journal. 2016;9(4):583–591. DOI: https://doi.org/10.1093/ckj/sfw047.Becherucci F, Roperto RM, Materassi M, Romagnani P. Chronic kidney disease in children. Clinical Kidney Journal. 2016;9(4):583–591. DOI: https://doi.org/10.1093/ckj/sfw047.Tian J, Niu L, An X. Cardiovascular risks in chronic kidney disease pediatric patients. Experimental and Therapeutic Medicine. 2017;14(5):4615–4619. DOI: https://doi.org/10.3892/etm.2017.5117.Tian J, Niu L, An X. Cardiovascular risks in chronic kidney disease pediatric patients. Experimental and Therapeutic Medicine. 2017;14(5):4615–4619. DOI: https://doi.org/10.3892/etm.2017.5117.Alrashdi JS, Hashim HA, Mahmoud MZ, Alosaimi FK, Alonazi B, Alsaadi М, et al. The spectrum of renal pathologies in saudi pediatrics patients using ultrasound. Pakistan Journal of Biological Sciences. 2020; 23(12):1614–1620. DOI: https://doi.org/10.3923/pjbs.2020.1614.1620.Alrashdi JS, Hashim HA, Mahmoud MZ, Alosaimi FK, Alonazi B, Alsaadi М, et al. The spectrum of renal pathologies in saudi pediatrics patients using ultrasound. Pakistan Journal of Biological Sciences. 2020; 23(12):1614–1620. DOI: https://doi.org/10.3923/pjbs.2020.1614.1620.Oliveira EA, Mak RH. Progression of chronic kidney disease in children — role of glomerular hemodynamics and interstitial fibrosis. Current Opinion in Pediatrics. 2018;30(2):220–227. DOI: https://doi.org/10.1097/mop.0000000000000594.Oliveira EA, Mak RH. Progression of chronic kidney disease in children — role of glomerular hemodynamics and interstitial fibrosis. Current Opinion in Pediatrics. 2018;30(2):220–227. DOI: https://doi.org/10.1097/mop.0000000000000594.Akhmetshin RZ. Predictors of progression of chronic kidney disease in children with malformations of the urinary system. Experimental and Clinical Urology. 2017;(1):126–130. (In Russ.). EDN: https://www.elibrary.ru/zehpip.Akhmetshin RZ. Predictors of progression of chronic kidney disease in children with malformations of the urinary system. Experimental and Clinical Urology. 2017;(1):126–130. (In Russ.). EDN: https://www.elibrary.ru/zehpip.Nее A, Sergeeva EV, Bykova OG, Semeshina OV, Gordeets AV. Clinical and epidemiological features of urinary tract infection in children of Primorsky Krai. Pacific Medical Journal. 2019;(4):10–13. (In Russ.). DOI: https://doi.org/10.34215/1609-1175-2019-4-10-13.Nее A, Sergeeva EV, Bykova OG, Semeshina OV, Gordeets AV. Clinical and epidemiological features of urinary tract infection in children of Primorsky Krai. Pacific Medical Journal. 2019;(4):10–13. (In Russ.). DOI: https://doi.org/10.34215/1609-1175-2019-4-10-13.Sitnikova EP, Pukhova TG, Spivak EM. Epidemiology and clinic of microbial-inflammatory nephropathy in children living in an ecologically unfavorable region. Children Infections. 2022;21(1):29–32. (In Russ.). DOI: https://doi.org/10.22627/2072-8107-2022-21-1-29-32.Sitnikova EP, Pukhova TG, Spivak EM. Epidemiology and clinic of microbial-inflammatory nephropathy in children living in an ecologically unfavorable region. Children Infections. 2022;21(1):29–32. (In Russ.). DOI: https://doi.org/10.22627/2072-8107-2022-21-1-29-32.Stein D, McNamara E. Congenital anomalies of the kidneys and urinary tract. Clinics in Perinatology. 2022; 49(3):791–798. DOI: https://doi.org/10.1016/j.clp.2022.06.002.Stein D, McNamara E. Congenital anomalies of the kidneys and urinary tract. Clinics in Perinatology. 2022; 49(3):791–798. DOI: https://doi.org/10.1016/j.clp.2022.06.002.Chevalier RL. CAKUT: A pediatric and evolutionary perspective on the leading cause of CKD in childhood. Pediatric Reports. 2023;15(1):143–153. DOI: https://doi.org/10.3390/pediatric15010012.Chevalier RL. CAKUT: A pediatric and evolutionary perspective on the leading cause of CKD in childhood. Pediatric Reports. 2023;15(1):143–153. DOI: https://doi.org/10.3390/pediatric15010012.Morozov SL, Dlin VV. Pyelonephritis in children. A modern look at the problem. Paediatrician Practice. 2020;(1):32–39. (In Russ.). EDN: https://www.elibrary.ru/kbhclc.Morozov SL, Dlin VV. Pyelonephritis in children. A modern look at the problem. Paediatrician Practice. 2020;(1):32–39. (In Russ.). EDN: https://www.elibrary.ru/kbhclc.Lysova EV, Savenkova ND. Frequency of CAKUT syndrome in the etiological structure of chronic kidney disease (CKD) in children and adolescents. Russian Bulletin of Perinatology and Pediatrics. 2016;61(4): 212–213. (In Russ.). DOI: https://doi.org/10.24884/1561-6274-2017-3-69-74.Lysova EV, Savenkova ND. Frequency of CAKUT syndrome in the etiological structure of chronic kidney disease (CKD) in children and adolescents. Russian Bulletin of Perinatology and Pediatrics. 2016;61(4): 212–213. (In Russ.). DOI: https://doi.org/10.24884/1561-6274-2017-3-69-74.Safina EV, Zelentsova VL. Nephropathy in young children, factors of their early implementation (review). Ural Medical Journal. 2017;(5):90–95. (In Russ.). EDN: https://www.elibrary.ru/ysyttf.Safina EV, Zelentsova VL. Nephropathy in young children, factors of their early implementation (review). Ural Medical Journal. 2017;(5):90–95. (In Russ.). EDN: https://www.elibrary.ru/ysyttf.Sert S, Müller D, Thumfart J. Factors associated with the development of chronic kidney disease in children with congenital anomalies of the kidney and urinary tract. Frontiers in Pediatrics. 2020;8:298. DOI: https://doi.org/10.3389/fped.2020.00298.Sert S, Müller D, Thumfart J. Factors associated with the development of chronic kidney disease in children with congenital anomalies of the kidney and urinary tract. Frontiers in Pediatrics. 2020;8:298. DOI: https://doi.org/10.3389/fped.2020.00298.Gök ES, Ayvaci A, Ağbaş A, Adaletli İ, Canpolat N, Sever L, et al. The frequency of familial congenital anomalies of the kidney and urinary tract: Should we screen asymptomatic first-degree relatives using urinary tract ultrasonography? Nephron. 2020;144(4):170–175. DOI: https://doi.org/10.1159/000505402.Gök ES, Ayvaci A, Ağbaş A, Adaletli İ, Canpolat N, Sever L, et al. The frequency of familial congenital anomalies of the kidney and urinary tract: Should we screen asymptomatic first-degree relatives using urinary tract ultrasonography? Nephron. 2020;144(4):170–175. DOI: https://doi.org/10.1159/000505402.Ristoska-Bojkovska N. Congenital anomalies of the kidney and urinary tract (CAKUT). Prilozi. 2017; 38(1):59–62. DOI: https://doi.org/10.1515/prilozi-2017-0008.Ristoska-Bojkovska N. Congenital anomalies of the kidney and urinary tract (CAKUT). Prilozi. 2017; 38(1):59–62. DOI: https://doi.org/10.1515/prilozi-2017-0008.Yin S, Peng Q, Li H, Zhang Z, You X, Fischer K, et al. Multi-instance deep learning of ultrasound imaging data for pattern classification of congenital abnormalities of the kidney and urinary tract in children. Urology. 2020;142:183–189. DOI: https://doi.org/10.1016/j.urology.2020.05.019.Yin S, Peng Q, Li H, Zhang Z, You X, Fischer K, et al. Multi-instance deep learning of ultrasound imaging data for pattern classification of congenital abnormalities of the kidney and urinary tract in children. Urology. 2020;142:183–189. DOI: https://doi.org/10.1016/j.urology.2020.05.019.Safina EV, Zelentsova VL, Myshinskaya OI. Analysis of the structure of congenital defects of the urinary system in children according to ultrasound screening data. Nephrology and Dialysis. 2020;22(4):571–572. (In Russ.). DOI: https://doi.org/10.28996/2618-9801-2020-4-555-577.Safina EV, Zelentsova VL, Myshinskaya OI. Analysis of the structure of congenital defects of the urinary system in children according to ultrasound screening data. Nephrology and Dialysis. 2020;22(4):571–572. (In Russ.). DOI: https://doi.org/10.28996/2618-9801-2020-4-555-577.Spivak EM, Pukhova TG. The influence of environmental pollution factors on the morphofunctional state of the kidneys in children. Bulletin of the Ivanovo Medical Academy. 2021;26(1):48–53. (In Russ.). DOI: https://doi.org/10.52246/1606-8157_2021_26_1_48.Spivak EM, Pukhova TG. The influence of environmental pollution factors on the morphofunctional state of the kidneys in children. Bulletin of the Ivanovo Medical Academy. 2021;26(1):48–53. (In Russ.). DOI: https://doi.org/10.52246/1606-8157_2021_26_1_48.

The authors declare that there are no conflicts of interest present.