Violation of renal and peripheral hemodynamics in the development of cardiovascular disorders in children with chronic pyelonephritis
Background. Prompt detection of changes in the cardiovascular system in children with chronic pyelonephritis is important for slowing down the development of arterial hypertension and the progression of chronic kidney disease. Nowadays, daily monitoring of blood pressure and ultrasound Doppler of the renal vessels are the up-to-date non-invasive methods for early diagnosis of cardiovascular disorders. The purpose of the study was to determine the prognostic value of ultrasound symptoms of renal hemodynamic disorders and daily blood pressure monitoring in children with chronic pyelonephritis. Materials and methods. The correlation analysis of indicators of daily blood pressure monitoring and ultrasound Doppler examination have been performed in 107 children aged 3–17 years with chronic pyelonephritis. Results. There was statistically significant correlation between such indicators as pulsation index, resistance index, systolic-diastolic ratio at the level of stem, segmental renal arteries and daily indexes (blood pressure, systolic pressure and diastolic pressure), variation coefficient at night, mean diastolic pressure and diastolic pressure at night. However, correlation between ultrasound indicators of renal hemodynamics and daily blood pressure monitoring at the level of interlobular renal arteries was statistically unreliable. Furthermore, children with chronic pyelonephritis on the background of urinary tract abnormalities had the strongest associations between the indicators of the peripheral resistance at the level of the stem renal arteries and the indexes of daily blood pressure monitoring. Conclusions. Indicators of renal hemodynamics — pulsation index, index of resistance, systolic-diastolic ratio at the level of the stem and segmental arteries of the kidney can distinguish the features of renal hemodynamics in order to predict the development of renal hypertension in children with chronic pyelonephritis. The intensity of deviations of these parameters from the normal rates of renal hemodynamics determines the severity of arterial hypertension in 57 % of cases.
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