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P322 Treatment optimisation of steroid-resistant paediatric nephrotic syndrome
  1. Plotnikova E.V,
  2. Borisova M.A,
  3. Belova E.G,
  4. Borisov V.S
  1. Children’s diagnostic centre of the Pirogov National Medical and Surgical Centre, Moscow, Russian Federation

Abstract

Introduction An important question of increasing the number of patients with progression of chronic kidney disease. Speed the development of nephrosclerosis varies both from morphological forms of chronic glomerulonephritis and availability factors in progression, one of which is hyperlipidemia.

Aim The purpose of the research is to conduct a comprehensive clinical laboratory evaluation of the effectiveness of therapeutic assistance to children with hyperlipidemia patients with glomerulonephritis and steroid-resistant nephrotic syndrome (SRNS).

patients and methods: studied 30 children aged 7 to 17 years old, the average age of 13.4±0.94 a year. We formulated by method of a random sample 2 groups of 15 people. All children permanently treated were examined in 2009–2013. To assess lipid profile indices were studied: total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC) enzymatic colorimetric method using reagent kits of firm «HUMAN» (Germany). Method to determine the index of the polyunsaturated fatty acid ω−3 (ω−3 LCD) gas chromatography with mass detection and electron impact ionisation on analyzers Agilent 6850/5375 and Shimadzu GS 17A/GSMS-QP 5050.

Results within 6 months in 1 group, to immunosuppressive therapy added drugs ω−3 triglycerides (ω−3 TG) (ratio of eicosapentaenoic acid and docosahexaenoic acid=1,2/1). Patients in the 2 group received standard immunosuppressive therapy. 14 children have from 1 group with steroid-resistant nephrotic syndrome (SRNS) and hyperlipidemia (LDL) lowering the level of observed (up to 4.58±0.61 therapy after treatment 2.99±0.45) (p=0.03), TG (prior to therapy (3.77±0.54) after treatment (1.74±0.22) (p=0.006), reducing proteinuria (up to 2.48±1.18 therapy after therapy 0.53±0.22) (p=0.04) increase index ω−3 LCD (to treat 2.85%±0.36, amid a 6 month therapy 11.8%±2.059) (p=0.02) in the complex treatment of the SRNS in the blood of these children compared with children from 2 groups not receiving ω−3 TG. Revealed an increase in the level of the index ω−3 LCD when taking ω−3 triglycerides (before treatment 2.85%±0.36) through 6 months of treatment (post-treatment 11.8%±2.06) (p=0.02), as compared to children with SRNS, not obtaining the ω−3 TG (2.7%±0.17 vs 4.15%±0.45) (p=0.33). In group 2 decrease LDL (up to 4.87±0.64 therapy after treatment 3.86±0.56 (p=0.45), TG (prior to therapy (3.61±0.95) after treatment (2.54±0.51), but reliable differences is not obtained (r=0.27). reducing proteinuria in group 2 reached reliable differences (up to 2.39±1.09 therapy after therapy 0.77±0.26) (p=0.04).

Conclusion according to the information on the background of the supplementary admission ω−3 triglycerides noted hipocholesterinemia, hipotrigliceridemia, anti-atherogenous action with SRNS, which makes it useful to include data products in basic therapy in this group of patie

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