The significance of early detection of nephrogenic anemia in young children with infections of the urinary system and pyelonephritis

In the general structure of childhood diseases, infections of the urinary system (IUS), including pyelonephritis (PN), in terms of prevalence (more than 5 % in girls and 1–2 % in boys) rank second after respiratory tract infections. It is still unsolved how to detect early and retard the progression of kidney diseases of various etiologies with the delay in the formation of chronic kidney disease (CKD), and to decrease the risk of complications caused by renal dysfunction. It has been known that already at I–II stages of CKD, more than half the children have nephrogenic anemia (NA). It is characterized not only by a decrease in the hemoglobin content in the blood but also by a decrease in the number of erythrocytes below 4–4.5*10 12 /l, and a normochromic-normocytic character, namely, a normal level in the average volume of erythrocytes (MCV) – to more than 75 fl, and a color index close to 0.85. Out of 650 sick children aged 2 months to 3–4 years who were treated in the infectious diseases department of early age 3 GDKB from January to November 2021, NA was detected in 49 children with IMS, of which NA in combination with iron deficiency anemia (IDA) in 19 patients. In all these patients, NA was affected by leukocyturia, proteinuria, bacteriuria; 39 were diagnosed IUS with and 10 with PN. But in 3 more patients, NA was affected by anomalies of the urinary system (duplication of the kidney, hypoplasia of one kidney, etc.), without leukocyturia. Considering the above, the identification by pediatricians of NA in young children with IUS, or with other pathology of the kidneys and urinary tract should serve as an indication for the urgent referral of these patients to a nephrologist for further examination and the prescription of proper treatment.

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