No abstract

Purpose of the Study: assessment of the course and outcomes of the lupus nephritis in children; determination of the efficiency of use of the angiotensin-converting enzyme inhibitors for the lupus nephritis. Children Characteristics and Study Methods. Over a 20-year period, we analyzed the data of 36 children with the systemic lupus erythematosus and lupus nephritis at the ages from 5 to 17 years. Results. In 72.2% of the cases, the kidney damage was noted at the disease onset, and the severe, recurrent course of the lupus nephritis was registered. The nephrotic syndrome has developed in 47.2% of cases. All patients received the comprehensive treatment: corticosteroids, cyclophosphamide, azathioprine, selective immunosuppressants. A study was conducted for 23 children to determine the efficiency of the enalapril treatment prescribed for the purpose of the nephroprotection. It was revealed that this drug improves the long-term results. There was registered the twofold decrease in the disease recurrence rate, fivefold decrease in the level of daily proteinuria. Five-year survival rate was observed in 100% of the patients, 10-year – in 91.6%, end-stage renal failure was diagnosed in 8.4% of the children. 5 patients died in adult life (mortality rate is 13.9%). Conclusion. The children with the lupus nephritis require the continuation maintenance therapy. The use of the selective immunosuppressants and nephroprotectors has contributed to the renal survival.

In a comparative study of exogenous and endogenous factors contributing to the formation of urinary system pathology in childhood, it was found that children from families with patients with nephropathy have the highest risk [1].