The incidence rate of renal and urinary system diseases in children (fig. 8.1) takes 8th place, infectious and inflammatory diseases in the first place. The features of their course in children are as follows.
• More than 50% of kidney diseases are asymptomatic or with minimal changes in urinalysis.
• Clinical signs and the course of disease in young children are significantly different from older children due to age-related features of the structure and functioning of the urinary system.
• Children often have conditions that mimic urinary tract system lesions which causes significant diagnostic difficulties.
• About 80% of urinary system diseases in adults debut in childhood. This greatly increases the doctor's responsibility for timely diagnosis, treatment and rehabilitation of patients.
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Fig. 8.1. Kidney structure with localization of disease: a - kidney: 1 - renal cortex; 2 - renal medulla consisting of renal pyramids; 3 - renal pelvis; 4 - renal artery; 5 - renal vein; 6 - ureter; b - nephron: 1 - ascending arteriole; 2 - Shumlyansky-Bowman capsule; 3 - glomerulus; 4 - proximal tubule; 5 - capillary network surrounding the tubule, 6 - renal vein (colored arrows show the necessary substances, black - the substances to be removed)
INFECTIOUS AND INFLAMMATORY DISEASES
Pyelonephritis
Pyelonephritis is bacterial inflammation caused by infection of the pyelocaliceal system and tubular and interstitial tissue of the kidneys. Deinition by clinical practice guidelines.
Acute pyelonephritis is an inflammatory disease of the renal parenchyma and pelvis resulting from bacterial infection.
Chronic pyelonephritis is damage to the kidneys manifesting with ibrosis and deformation of the pyelocaliceal system as a result of repeated attacks of MVH1 infection. As a rule, it occurs in case of urinary tract malformations or obstruction.