Introduction. A comprehensive analysis of the polymorphisms of the genes of the renin-angiotensin system in children with different nosological forms of nephropathies is a necessary step in determining the clinical and genetic features of the formation of chronic kidney disease (CKD). Aim: to establish the features of ACE (D/I), GT (Thr174Met), AGT (Met235Thr) and AGTR1 (A1166C) gene polymorphisms in CKD children and determine their significance in the progression of the disease. Materials and methods. A retrospective and prospective study included one hundered 1 to 17 years children with nephropathies, examined in the children’s nephrology department of the Samara Regional Hospital over 10 years. In children, the identification of single nucleotide polymorphisms of genes was carried out using an allele-specific polymerase chain amplification reaction using test systems. Evaluation of clinical and paraclinical markers of progression in CKD was carried out twice a year. The results of the study were evaluated with the calculation of the Student–Fisher criteria and correlation analysis. Results. in patients with kidney diseases, there was a trend towards an increase in the occurrence of single nucleotide polymorphisms of genes that affect the renin-angiotensin system (RAS). CKD patients at the stage 3–5 accounted for 35%. They had D/D ACE alleles combined with alleles AGT Thr174Met (27.9 ± 6.83%) and Met235Thr (41.86 ± 7.5%), Thr235Thr (30.2 ± 7.0%) and AGTR1 A1166C (37.2 ± 7.32%) more often than in milder CKD (0 and 7.5 ± 3.37%; 5.2 ± 2.94% and 5.2 ± 2.94%; respectively, p ≤ 0.010). Соnclusion. The study of clinical and genetic features of CKD is relevant for the purpose of timely implementation of preventive measures.

Chronic kidney disease and a decrease in its progression is a global health problem. However, the risk factors associated with the primary nosology of glomerular diseases of children have not been sufficiently studied.Purpose. To determine early risk factors for the progression of chronic kidney disease for more effective prevention of chronization of the process, based on the analysis of clinical and anamnestic data, the features of the manifestation of the primary developed glomerular pathology, and taking into account nosological forms.Material and methods. The experience of own clinical observations, retro- and prospective, related to the formation of chronic kidney disease of children with glomerular pathology is summarized. The study was conducted on the basis of the children’s uronephrological center of the Samara Regional Clinical Hospital named after V.D. Seredavin.Results. The universal risk factors are systematized: transferred critical conditions in the perinatal period with the development of acute kidney injury; prenatally established CAKUT syndrome; the presence of a genetic predisposition to kidney diseases, a complex of allergic diseases in the family; the carriage of persistent infections, hemolytic strains of streptococcus, social determinant, environmental conditions, etc. Specific early risk factors for disease progression, features of the onset of kidney pathology and biomarkers of progression that determine early kidney damage have been identified. The features of nephroprotection are formulated: interdisciplinarity with the inclusion of organizational, social components; operational communication with the outpatient link; the use of social networks for educational processes — the patient’s family, training of first-contact doctors.

Currently, the attention of the medical community to a non-invasive method of laboratory diagnostics - the study of oral fluid (oral, saliva, saliva test) in various fields of clinical medicine and mainly in adult patients has been updated. Saliva testing has shown good results, especially in the areas of genomics, microbiomics, proteomics, metabolomics, and transcriptomics. The review presents the possibilities of using a non-invasive method for infectious and non-infectious diseases in children. Saliva contains a wide range of protein DNA and RNA biomarkers that help detect many viral infections in children. Oral fluid tests for human immunodeficiency virus, hepatitis B virus have improved access to diagnostics for infants. Both serological and molecular analyzes of the oral fluid are suitable for routine examination and early detection of measles virus RNA, polyomaviruses. Angiotensin-converting enzyme-2 receptor expression was found in the saliva of children with COVID-19, which can be used to diagnose SARS-CoV-2. The saliva test is as effective as the standard test at identifying asymptomatic individuals in contact tracing. The possibilities of saliva diagnostics are positively assessed in transplantology. New biomarkers in saliva have been identified for the diagnosis of many somatic diseases in children. The role of oral fluid as an alternative to blood serum in patients with terminal renal failure, chronic kidney disease (determination of creatinine, urea) in both adults and children is shown. The data obtained may influence the recommendations for the treatment of patients. As a non-invasive method, the study of oral fluid is promising for the diagnosis, prognosis, monitoring of diseases, large-scale typing of children, and the search for new biomarkers.

No abstract