We investigated activity of the nitric oxide (NOS) in the kidney in 16 children with congenital hydronephrosis and secondary pyelonephritis. We used histochemical method on NADPH-diaphorase (Hope, Vincent, 1989), which reflects total activity of NOS. We found significantly increasing of NOS activity’s in proximal and distal tubules and renal vessels during early stages of disease (0-3 years), in comparison with control group ( n = 8) of healthy children. Total depression of NOS activity in kidneys was detected in patients with duration of disease more than 10 years. All of them had moderate arterial hypertension and nephrosclerosis. Thus, decreasing of NO in the renal tissue may be one of pathways development of arterial hypertension in children with obstructive pyelonephritis.

Аcute tubular necrosis (ATN) is an often complication of kidney transplantation. The aim of this study was to compare the effect of two regimes of dialysis in patients after kidney transplantation on frequence and duration of ATN. We analyzed the results of treatment of 134 patients with renal grafts: 104 were treated with hemodialysis and 30 - with peritoneal dialysis. ATN was observed in 37 (35,6%) patients on hemodialysis and in 10 (33,3%) - on peritoneal dialysis. The duration of oliguric period was about 12 and 10 days. It has been found that there was no difference in duration and frequence of ATN between these two groups of recipients of renal grafts. But the patients on peritoneal dialysis tolerated the treatment better becourse the changes in AP, intra and extracellular fluids volume, concentration of urea, creatinine, eletrolytes in blood were lower in the peritoneal dialysis group.

An investigation of the reaction of kidneys to oral protein preparation was carried out to study the renal functional reserve. The loading included 1,0 g of protein per kg of body mass in 50 children with chronic pyelonephritis. Was shown that the renal functional reserve depend of the activity of renal process, extent of loss of the functioning renal tissue, presence arterial hypertension. Decresing of renal functional reserve in children with chronic pyelonephritis was associated with increase of absolute excretion and excreted fraction of calcium, in children with high extent of loss of the functioning renal tissue, urolithiasis and arterial hypertension was decresed diuresis.

The aim of investigation was the study of the effect of angiotensin-converting enzyme inhibitors (lisinopril) on lipid metabolism in children and adolescents with diabetes mellitus type 1 complicated with diabetic nephropathy 3 stage (Mogensen, 1983). We observed 35 microalbuminuric patients aged from 10 to 9 years old with 3-14 years diabetes duration. They had been treated with an intensified insulin regimen with human insulin. Blood levels of total cholesterol, low density lipoproteins decreased significantly, high density lipoproteins increased and microalbuminuria have been reduced after 4 weeks treatment with lisinopril. However remained dyslipidemia and microalbuminuria require more long administration of angiotensin-converting enzyme inhibitors.

We evaluated an efficacy of mycophenolate mofetil (MMF) in 6 children with glomerulonephritis. The 12 months treatment was effective in reducing of proteinuria in all patients - 77% from baseline level. One child with focal segmental glomerulosclerosis achieved of partial remission of disease with normalized of albumin and creatinine levels in serum and GFR. 2 children had transient of decreasing virus-induced immunity as an adverse effect of treatment with MMF. We need randomized controlled trials in order to confirm of efficacy of MMF in children with glomerulopathies.

The aim of the study was to evaluate the incidence of kidney disease in multiple myeloma (MM) patients in Baikal region and to determinate the independent predictors of renal insufficiency (RI) and its progression. 102 patients with multiple myeloma were examined. Forms, stage, degree of risk, immunochemical variants and MM course, β₂ blood microglobulin, SRB were determined. Kidney function was examined at the moment of disease diagnostics and during treatment: serum creatinine level, glomerular filtration rate (GFR) by Cockcroft-Gault formula, were examined. At the moment of MM diagnostics 32% of all patients have had kidney dysfunction, 63% of all patients have had GFR < 29 ml per min. The highest MM frequency with RI in debut of disease fall at the age of 60-69 years, women prevail. The majority of RI patients in debut of disease have III stage of MM (47% of all), progressing course (47% of all), high degree of risk (50% of all), BJ variant (44% of all). BJ λ (57%) prevails among BJ variant. The majority of patients with RI in debut of disease had Hb < 85 g/l. 59% of all patients had high level of СRB, 56% had increase of β₂ microglobulin. Conclusion : High risk of kidney dysfunction take place while revealing III stage of MM with progressive course, high degree of risk of MM progression, BJ λ variant, anemia with Hb < 85 g/l and with increasing of СRB.

To investigate the impact of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and angiotensinogen (AGT) gene T174M polymorphisms on the prevalence and progression of nephrotic syndrom (NS) in children, we determined the ACE I/D genotype and AGT genotype in 80 Russian children with NS including 15 children with chronic renal failure (CRF). Genotype frequencies did not differ between patients with NS and controls (n = 165). The distribution of ACE and AGT genotypes was similar among NS subgroups, such as focal segmental glomerulosclerosis (FSGS) (n = 12), steroid-sensitive nephrotic syndrome (n = 32), nephrotic syndrome with hypertension (n = 22), and also it was no difference with control group. When NS subjects with CRF (n = 15) were compared to controls, the prevalence of ACE-DD genotype was significantly higher (47% vs 21%; c2 = 4,44; p < 0,05). Our results indicate that the DD genotype of ACE may be a risk factor for the dеvеlopment of progressive renal impairment in children with nephrotic syndrome.