[Nutritional management of kidney diseases in children].

The prevalence of various kidney diseases in children remains high in recent decades. Adequate nutrition management can enhance the effectiveness of drug treatment, slow the frequency of relapses andprevent the progression of the disease. The article is devoted to modern approaches to diet therapy in various kidney diseases in children with the defeat of tubular and glomerular appa ratus. For the first time the therapeutic diets for children with various kidney diseases are presented. Particular attention is paid to diet therapy in nephrotic syndrome (steroid-responsive and steroid-refractory). Dietary approaches with modern formulas for enteral nutrition in cases of steroid therapy complications in children with renal insufficiency (in predialysis stage and on dialysis) are described. Differentiated nutritional approaches for patients with different types of crystalluria are separately presented.

[Effects of vitamin D metabolites on indicators of protein, phosphorus and calcium metabolism in children with chronic renal failure]. / Vliianie metabolitov vitamina D na pokazateli belkovogo i fosforno-kal'tsevogo obmena u detei s khronicheskoi pochechnoi nedostatochnost'iu.

Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of patients with renal failure and osteodystrophy on vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid metabolism and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with vitamin D metabolites. Vitamin D metabolites didn't influence retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.

[Effectiveness of beta-carotene for treatment of erosive ulcerative changes in gastric and duodenal mucosa in children with chronic glomerulonephritis]. / Otsenka éffektivnosti primeneniia beta-karotina pri érozivno-iazvennykh izmeneniiakh slizistoi obolochki zheludka i dvenadtsatiperstnoi kishki u detei s khronicheskim glomerulonefritom.

The peptic ulcer of stomach and duodenum are the more often occuring complications of steroid treatment in children with chronic glomerulonephrite. Dinamic investigation has shown that the using of beta-carotin oily solution in therapy of this complications increases the efficiency of traditional treatment. It has been shown that beta-carotene administration speeds the reparation of stomach and duodenum ulcers, saves adequate serum concentration of beta-carotene and retinol. The data obtained demonstrate that beta-carotene administration in the complex therapy of chronic glomerulonephrite patient with gastroenteropathy should be recommended.

[Effect of vitamin D metabolites on the markers of protein, calcium and phosphorus turnover in children with chronic renal failure]. / Vliianie metabolitov vitamina D na pokazatelibelkovogo i fosforno- kal'tsievogo obmena u detei s khronicheskoi pochechnoi nedostatochnost'iu.

Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of the patients with renal failure and osteodystrophy on the Vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid turnover and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with the vitamin D metabolites. Vitamin D metabolites didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.

Clinical application of the polyunsaturated n-3 fatty acids usage in pediatric practice.

The investigation of the effectiveness of a diet supplemented with n-3 PUFA in children with glomerulonephritis was done. Patients receiving "Polyen" achieved better clinical remission, more rapid decrease of hypercholesterolemia, and hypercoagulation than the patients from the control group. We can recommend "Polyen" usage in the treatment of glomerulonephritis in children.

[Use of the fish oil "Polyen" in pediatric practice]. / Opyt primeneniia ryb'ego zhira "polien" v pediatricheskoi praktike.

The effects of supplementation of basic diets with 'Polyen' in daily doses of 2.5-4.0 g during 30-40 days together with antioxidants were studied in patients with kidney diseases (diet No7, n = 14), different allergies (hypoallergenic diet, n = 37) and in control children (n = 12). It was shown positive dynamics in fatty acid contents in plasma and red blood cell membranes, in humoral and cell immunity indicators and in improving of clinical symptoms of diseases. 'Polyen' is recommended for wide use in pediatric practice.

[Effects of vitamin D on protein turnover in children with renal osteopathy]. / Vliianie vitamina D na pokazateli belkovogo obmena u detei s renal'nymi osteopatiiami.

Amino acid analysis and investigation of nitrogen balance were done in 2 groups of the patients with renal failure and osteodystrophy on the diet and vitamin D treatment. The results of the investigations confirm vitamin D influence on free amino acid turnover. We observed significant elevations of plasma amino acids in patients treated with the diet and vitamin D in comparison with the patients without vitamin D supplementation. Vitamin D didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure

[Rate of progress of chronic renal insufficiency during low-protein diet]. / Skorost' progressirovaniia khronicheskoi pochechnoi nedostatochnosti v usloviiakh nizkobelkovoi diety.

The rate of progress of chronic renal insufficiency (CRI) under conditions of a diet with a moderate protein content and during a free diet was studied in 40 children with tubulointerstitial renal diseases and glomerulonephritis by determining the dependence of reciprocal serum creatinine on the time. A low-protein diet had a positive effect on the rate of CRI progress in children with tubulointerstitial diseases of the kidneys. The prognostic error--the difference between the foretold and the true period of time to the "death of the kidney" was 12% on the average.

[The amino acid spectrum of plasma and erythrocytes in children with kidney diseases at the stage of chronic kidney insufficiency]. / Aminokislotnyi spektr plazmy i éritrotsitov pri bolezniakh pochek v stadii khronicheskoi pochechnoi nedostatochnosti u detei.

The effect of diets with varying protein restrictions on the amino-acid spectrum of plasma and erythrocytes was studied in 46 children with total chronic renal insufficiency (CRI), stages I and II, resultant from tubulo-interstitial diseases of the kidneys and glomerulonephritis. Qualitative and quantitative changes in the spectrum of blood amino acids are recorded at the initial stage of CRI and depend on the degree of protein restriction in the diet. The diet with a sharp protein restriction (Giordano-Giovanetti type) produces hypoazotemic effect and possesses anabolic properties. Disorders in amino-acid metabolism serve indications for using essential amino acids and their ketoanalogues in children with uremia.

[Urinary excretion of oxalates and urates in a nephrotic form of glomerulonephritis in children]. / Ekskretsiia oksalatov u uratov s mochoi pri nefroticheskoi forme glomerulonefrita u detei.

Diurnal excretion of oxalates and urates with urine was examined in 31 children with nephrotic chronic glomerulonephritis. Active glomerulonephritis was demonstrated to be attended by hyperuraturia. Hyperuraturia and hyperoxaluria occurred in the treatment with immunosuppressants, diuretics and correlated with the impairment of other tubular functions of the kidneys.

[Use of vitamin D 2 and its metabolites in chronic glomerulonephritis in children]. / Primenenie vitamina D2 i ego metabolitov pri khronicheskom glomerulonefrite u detei.

Comparative assessment of the action of vitamin D2 in high doses, of oxydevit and rocaltrol applied in renal osteopathies has demonstrated that they are equally effective in elevating the calcium concentration in blood serum occurring at the expense of its increased absorption by the intestine. At the same time certain differences have been discovered in the action of these agents on endocrine regulation. The data obtained provide evidence in favour of the use of vitamin D2 in high doses or of its metabolites not only in renal osteopathies at the stage of chronic renal failure but also in the management of the disorders of phosphorus-calcium metabolism in patients with the nephrotic syndrome in the functional-compensation stage after continuous use of corticosteroids, heparin and diuretics.

[Phosphorus-calcium metabolism and dietetic correction of its disorders in chronic kidney diseases in children]. / Sostoianie fosforno-kal'tsievogo obmena i dieticheskaia korrektsiia ego narushenii pri khronicheskikh bolezniakh pochek u detei.

Ninety children with varying renal diseases were under observation. The investigations conducted have shown that disorders in phosphoric-calcium metabolism depend on the type, activity of chronic glomerulonephritis (CGN) and etiology of chronic renal insufficiency (CRI). Significant disorders in phosphoric-calcium metabolism were detected in patients with nephrotic and mixed types of CGN. Most manifest clinical and x-ray changes of the osseous system were observed in patients with CRI that developed as a result of the tubulointerstitial pathologic process. Low-phosphate diets with preset amounts of Ca and P were developed, composed of products with relatively low content of P, and of new dietetic products rich in Ca. The diets were used for correction of hyperphosphatemia in children with CGN and in those with CRI, simultaneously with drug therapy, to prevent or diminish disorders in phosphoric-calcium metabolism, and to reduce the risk of invalidism among children with chronic renal diseases.