To investigate changes in the diagnostic patterns, disease profiles courses and therapeutic strategies for severe forms of childhood nephrotic syndrome (NS), the clinical features of 1 349 children treated during two consecutive time periods, 1980-2000 (n=1 162) and 2001-2006 (n=187), were retrospectively reviewed. The significant increase in initial renal impairment, NS with hypertension, and NS with hypertension and hematuria was observed (27.7% vs 51.3%, 1.0% vs 5.3% and 16.4% vs 21.9%, respectively). The rate of both secondary steroid resistance (SR) and Focal Segmental Glomerulosclerosis increased significantly, (1.8% vs 5.6%, p=0.032, and 14.9% vs 29.0%, p=0.034, respectively). The initial renal insufficiency and hypertension were highly predictive of the development of stage 3 of chronic kidney disease (CKD3) among SR patients in a multivariate Cox regression (p=0.001) for years . A higher hazard of CKD3 in male SR patients from three to six years old was observed in 2001-2006. Kaplan-Meier survival curves revealed a shift in the cumulative probability of CKD3, indicating a slower decline of the renal function for SR NS in the years 2001-2006 (p=0.008): the estimated five-year CKD3 risk was 39.7% vs 27.7%. Achievements in inducing remission and retarding the development of CKD3 in combination with increased severity of NS indicate the effectiveness of domestic strategies of NS management.

Aim of the study: to study the indicators of cellular hypoxia and apoptosis in pediatric patients with nephritic type of chronic glomerulonephritis. Material and methods: 52patients with active stage of nephrotic type ofChronic glomerulonephritis were inspected. All patients were divided into groups of Chronic Kidney Disease (CKD) by the level of glomerular filtration rate (GFR). Detection of the hypoxia–induced factor (HIF) and antiapoptotic factor Bcl–xL in serum performed using Western Blotting assay and immunohistochemically on material of kidney biopsies. Imaging was done using confocal laser microscopy. Results: it has been found that the disease course is accompanied by increased levels of hypoxia–induced factor HIF–1a and decreased expression of antiapoptotic factor Bcl–xL (in plasma and on biopsies). Detected changes significantly depended on the degree of proteinuria and declining of glomerular filtration rate. Dependence between the levels of hypoxia–induced damages and level of kidney function impairment was documented. In children with Chronic Kidney Disease (SKDIst.) HIF–1a was at level 128.6±2.3% (P<0.01, compared to Control group), in children with CKD II–III st. – 141.3±1.9% (P<0.01, compared to Control group and CKD I st.). Level of antiapoptotic defense in children with nephrotic type of Chronic glomerulonephritis was related to the level of kidney function impairment as well. In group of patient with CKDIst. Bcl–xL expression was down–regulated to 75.1±2.2%, in group with CKDII–IIIst. — to 60.1+1.8% (P<0.01 and P<0.001, compared to Control group, respectively). The level of evaluated changes has a dependence on levels ofproteinuria and kidney function impairment. Conclusion. Studied parameters might be used as predictors of unfavorable disease course.

Abstract. The Institute of Nephrology of the Academy of Medical Sciences of Ukraine was established in 2001. Since then, the Institute has been constantly evolving and, currently, it is a national scientific, methodological and medical center in the field of nephrology. The achievements of the Institute's staff are recognized in Ukraine and the world scientific community. The article presents an analysis of the results of the Institute's activities for 2001-2021.

Background and Aims The problem of acute kidney injury (AKI) in children continues to be relevant for pediatric nephrology and pediatrics due to the increasing frequency and the lack of a unified approach to management and further monitoring of these patients. The aim of our study was to determine the etiology and outcomes of acute kidney damage in children. Method 101 patients (aged from 3 months) were studied in referral center from early period after AKI (first month) to 18 years old. They were observed every 6 months during first year of disease course, and once per year till transfer to adult clinic. The outcomes were identified as complete recovery, isolated albuminuria and chronic kidney disease (CKD). The AKI outcomes were analyzed up to 1.5-3, 5-10 and 15 years of follow up (stage 1, 2 and 3, respectively). Results The predominant patients were males (72/71.3%). The most of the children were younger than 3 years old at the time of AKI (58/57.4%), and only a small part of patients were adolescents (7/6.9%). The hemolytic uremic syndrome (HUS) related to diarrhea was the main cause of the AKI (64/63.4%), and children of the first years of life formed the basis of this clinical group (0-3 years old: 44/68.8%). Sepsis and complicated acute viral and bacterial infections have also been confirmed as common AKI causes (12/11.9% and 8/7.9%, respectively). In some cases AKI were associated with hemolytic anemia (5/5.0%), acute glomerulonephritis (5/5.0%), vaccination (1/1.0%), contrast nephrotoxicity (1/1.0%) or unknown cause (3/3.0%). At stage 1 (1.5-3 years after event, n=60) complete remission were documented in 24/40.0%, albuminuria from 45 to 601 mg/day without other clinical signs – in 22/36.7%, and CKD 2-4 – in 12/23.3%. At stage 2 (5-10 years after event, n=54) complete remission were confirmed in 29/53.7%, persisted albuminuria – in 6/14.8%, and CKD 2-4 – in 19/31.5%. At stage 3 (15 years after event, n=12) CKD 2-4 were founded in all patients with arterial hypertension (n=7), focal-segmental glomerulosclerosis (n=2) and kidney cysts (n=3). Conclusion AKI was the most often in children of the first 3 years old, mainly in boys. The development of disease was firstly associated with HUS and severe infections. The long-term outcomes of AKI with distance from the event (AKI) to CKD even with recovery renal function and absence of clinical symptoms were difficult to predict. The prolongation of the observation period, the collaboration between the pediatric and adult centers, the widest usage of verified prognostic markers (i. g. albuminuria) and search for new ones are the most important options in post-AKI management.

The article presents the analysis of the native and foreign literature data and also the results of our own research devoted to studying the role of herpes virus infection in the appearance and course of glomerulonephritis in children. There has been described pathogenesis and clinical aspects of virus associated glomerulonephritis in children. Much attention has been paid to the diagnostic methods of herpes virus infection in glomerulonephritis. The importance of association of immunosuppressive and antiviral therapy has been underlined.