Pediatric urinary disorders manifested as urinary incontinence, compelling urges to urinate, etc. remain an important problem of contemporary healthcare. In spite of being extensively covered in the literature, urinary disorders, including enuresis, still present a diagnostic challenge to the physicians of primary healthcare facilities. Based on the findings of our retrospective study that revealed discrepancies between referral and final diagnoses of pediatric urinary disorders, we give recommendations to both physicians of primary healthcare facilities and their inpatient care colleagues that will help them to arrive at the correct diagnosis of a urinary disorder or concomitant bladder-bowel dysfunction using the proposed diagnostic algorithm.

Нарушения мочеиспускания у детей, проявляющиеся недержанием мочи, нестерпимыми позывами к микции и т. д., являются на сегодняшний день одной из актуальных проблем отечественного здравоохранения. Несмотря на широкое освещение данной проблематики в отечественных и зарубежных источниках литературы, у врачей особенно первичного звена здравоохранения регулярно возникают сложности в правильной диагностике расстройств мочеиспускания, в том числе энуреза. По результатам ретроспективного анализа расхождения направительных диагнозов (из первичного звена здравоохранения) и заключительных клинических диагнозов у детей с нарушениями мочеиспускания даны рекомендации по правильной диагностике расстройств мочеиспускания, а также сочетанных нарушений функции тазовых органов; предложен алгоритм диагностики данных нарушений.

According to current conception, the process of forming of nephrosclerosis despite the origins is detected by the force of the same cellular and molecular mechanisms. Hence primary triggers cause elevated production of range of cellular response mediators, cytokines and growth factors such as transforming plateled-derived growth factor, fibroblast growth factor, interferon gamma, nuclear factor and others, by means of sequential processes, is followed by the replacement of kidney tissue. One of the most studied aspects of the process of nephrosclerosis is the influence of anginotensin II. Therefore, despite the triggering factors, development and progression of nephrosclerosis all children with chronic renal disease are in a risk group with predisposition for renal insufficiency and it is required to prescribe nephroprotective therapy, i.e. the drugs that will influence one of the links of the nephrosclerosis, in order to slow down its progression. Currently, with nephroprotective goal in early age are used the following elements - angiotensin converting enzyme inhibitors and angiotensin receptors, antogonists (blockers). Lately, the active search for effective and safe drugs with nephroprotective effect on one side and great interest towards undiscovered before qualities of Vitamin D caused a huge amount of works that support the effect of Vitamin D. Prescription of Vitamin D to animals with uremia was followed by the drop of apoptosis of podocides and loss of the protein that is contained in the split diaphragm that caused decrease in proteinuria. Vitamin D suppresses protophibrotic TGF-B1 in tubular epithelial cells. The regression of tubulointerstitial phibrosis under the influence of Vitamin D was confirmed based on the cases of animals with obstruction of urethra. Along with the use of the mentioned above groups of drugs, which effectiveness was proved experimentally and clinically, we strongly believe the more thorough study of the Vitamin D drug use is needed, especially to study the prevention and slowing down of the progression of nephrosclerosis in the cases of children with chronic renal disease. It is crucial to detect the exact dosage of the drug, the prescription period and the methods for the control of the effective concentration of the drug.

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