Clinical Diagnostic Algorithms of Action in the Practice of a Doctor of General Practice – Family Medicine Diseases of the Urinary System in Children

Abstract

Chronic kidney disease (CKD) is the presence of markers of pathological changes in the urinary system lasting more than 12 weeks, regardless of their cause. The number of cases in children with diseases of the urinary system has documented confi rmed chronic kidney disease according to the implemented regional registry of patients with CKD, but its signifi cant spread is observed. Early manifestations of CKD are often underestimated and not treated in time. CKD and chronic renal failure are not a narrowly defi ned nephrological problem. Nowadays, military aggression and the consequences of the 2019 coronavirus pandemic (COVID-19), which led to the destruction of standard ways (patient clinical routes) in the provision of medical care, the issue of providing medical care to children on the basis of evidence- based and personalized medicine is of particular relevance in Ukraine, which, according to the WHO strategy, should meet the needs and be safe,eff ective, timely and of appropriate quality. The introduction of innovations in pediatric practice in terms of standardization of medical care helps the physician to act eff ectively in specifi c clinical situations, avoiding ineff ective actions. Involvement of specialists of other specialties (general practitioners- family medicine, endocrinologists, urologists, cardiologists, pediatricians, ophthalmologists) in the management of CKD without coordination of cooperation to ensure the principle of continuity complicates the diagnostic and/or therapeutic support of the patient. Early diagnosis, proper management tactics of pediatric patients with diseases of the urinary system at the outpatient stage is an important component in the provision of integrated, patient- oriented medical care in the practice of a general practitioner- family medicine. The article highlights the clinical and diagnostic algorithms of action of a general practitioner- family medicine regarding the tactics ofmanagement of pediatric patients with the most common nephrological symptoms: leukocyturia (bacteriuria), proteinuria and erythrocyturia. The scientifi c research was carried out within the framework of the Department of Pediatrics, Neonatology and Perinatal Medicine of the Bukovinian State Medical University. The research topics included: Research project on «Chronobiological and adaptive aspects and features of autonomic regulation in pathological conditions in children of diff erent age groups» (State registration number: 0122U002245, duration: 01.01.2022-31.12.2026).