The article presents a retrospective analysis of anamnestic and clinical and laboratory data of 42 case histories of children treated in the neonatal pathology department from 2015 to 2019. The study group of newborns had congenital malformations of the urinary system (CAKUT), the rest of the children made up the control group. The study was carried out on the basis of the regional perinatal center in Kursk. A comprehensive assessment of risk factors for the occurrence of malformations of the urinary system in newborns, a study of renal function in this group of patients using physical, laboratory and instrumental examinations, indicating the presence or absence of acute renal failure (ARF), was carried out. All newborns from the moment of birth to discharge from the hospital were under dynamic observation, the data of which were studied retrospectively from the records in the clinical history of the disease. The main indicators that were most thoroughly studied during the analysis were those that reflect the condition of the child in the presence of congenital malformations of the urinary system and satisfy the criteria for the diagnosis of acute renal failure. The data of obstetric and gynecological history of mothers, the presence of concomitant pathology in newborns, Apgar score at birth, clinical manifestations of renal failure (presence of pastiness, edema, microcirculation disorders, etc.), birth weight, general blood test data were analyzed urine, biochemical blood test, acid-base state for the first 7 days of life. The study identified the main risk factors leading to the development of congenital malformations in CAKUT (chorioamnionitis, intrauterine infection in early gestation, gestational arterial hypertension, toxoplasmosis, rubella, transferred during pregnancy), and also assessed the likelihood of developing acute renal failure in this category of newborns. 

Arterial hypertension (AHT) is a significant problem in the healthcare system. It is a major modifiable risk factor for cardiovascular disease (CVD), stroke, and renal failure. Long-term and persistent hypertension accelerates the progression of kidney disease to the terminal stage, and a progressive decline in renal function, on the contrary, increases blood pressure (BP) and worsens its control. Chronic kidney disease (CKD) is both a common cause of hypertension and a complication of uncontrolled hypertension. Hypertension and CKD are closely related by mixed causal relationships. Because hypertension can be a cause and effect of CKD, its prevalence is higher and more difficult to control. The interaction between hypertension and CKD is complex and increases the risk of adverse cardiovascular and cerebrovascular outcomes. The pathophysiology of hypertension in CKD is complex and is a consequence of many factors, including decreased nephron mass, increased sodium retention and expansion of extracellular volume, overactive sympathetic nervous system, activation of hormones, including the renin-angiotensin-aldosterone system, and endothelial dysfunction. Patients with CKD are more likely to have high-risk hypertension: latent, resistant and nocturnal hypertension. This literature review is devoted to modern concepts of the prevalence, pathogenesis, course, control, principles of hypertension treatment in CKD. The urgency of this problem is associated with an increase in the number of patients with hypertension and CKD worldwide and their high morbidity and mortality. The bi-directional nature of the relationship between hypertension and CKD makes it promising to study these two conditions in order to slow the rate of progression of renal and cardiac dysfunction. 

The morphological picture of the kidneys in patients with type 2 diabetes mellitus (DM) and arterial hypertension (AH) was studied according to autopsy data, and the results were compared with the structural features of the kidneys of persons suffering from AH without diabetes. A morphological study of kidney tissue was carried out in 30 persons (27 women and 3 men) aged 51 to 86 years, suffering from type 2 diabetes and hypertension, who died from acute cardiovascular failure in the intensive care unit of the general hospital of the State Clinical Hospital No. 9 (Saratov ) in 2017–2018. The duration of type 2 diabetes ranged from newly diagnosed diabetes to 30 years. The comparison group consisted of the results of autopsies of 10 individuals (9 women and 1 man) with AH without diabetes at the age of 50 to 80 years, whose cause of death was also acute cardiovascular failure. In the course of the morphological study of the kidneys in patients with type 2 diabetes mellitus and arterial hypertension, nephropathy of hypertensive genesis was diagnosed in 93.3% of cases, in 60% – a combination of diabetic and hypertensive nephropathy, in 33% – isolated hypertensive nephropathy. Comparison of morphological and clinical diagnoses of nephropathy revealed underdiagnosis of the latter on an outpatient basis. 

The presented review discusses the mechanisms of development, the issues of diagnosis and the possibility of therapy for IgAnephropathy. IgA-nephropathy is an immunocomplex lesion of the glomeruli, characterized by the predominant deposition of immunoglobulin A in the mesangia. IgA-nephropathy meets all the criteria of an immune-inflammatory disease and is a common type of chronic glomerulonephritis in all countries of the world. Changes in the molecular structure of IgA, disturbances in the processes of its glycosylation and polymerization, as well as the deposition of polymeric IgAl in the glomerular mesangium underlie the pathogenesis of the disease. There are primary, secondary, sporadic and familial forms of IgA-nephropathy. According to the clinical course, the classical, asymptomatic and atypical variants of the course of IgA-nephropathy are distinguished. Clinical manifestations of IgA-nephropathy consist of macro- or microhematuria, proteinuria and arterial hypertension. The final diagnosis is made with nephrobiopsy. Differential diagnosis is made between urolithiasis, renal tumor, secondary nephropathy, Alport syndrome, disease of thin basement membranes. In the treatment of IgA-nephropathy, blockers of the renin-angiotensin-aldosterone system are used; a positive effect of tonsillectomy is possible. Glucocorticoids and cytostatics are recommended for nephrotic proteinuria, rapid disease progression, or signs of renal activity on morphological examination. The prognosis is good, although approximately 40% of patients develop dialysis-dependent end-stage renal disease after 15 to 20 years. 

The article is an interdisciplinary educational dialogue between an infectious disease doctor and a therapist and aims to raise the awareness of therapists in terms of the diagnosis and treatment of infectious diseases. The topic of this article is the key signs of an infectious pathology occurring with damage to the kidneys and the urinary system as a whole. The most common clinical symptoms of kidney and urinary tract damage occurring in infectious diseases are briefly presented. Particular cases of kidney damage in viral infections: hepatitis and HIV infection are considered. In most cases, the kidneys are involved in the pathological process in infectious pathology, causing a wide range of injuries: from urinary syndrome to end-stage chronic kidney disease. The features of kidney damage in infectious diseases, such as urinary syndrome in the absence of other characteristic syndromes indicating kidney damage; acute kidney damage. It is indicated that kidney damage in acute infectious disease occurring against the background of chronic kidney disease is a trigger for its progressive course. Early detection and adequate therapy of an infectious disease can limit the degree and severity of the pathological process in the kidneys. The management of a patient suspected of having an infectious disease should be carried out with the involvement of an infectious disease doctor. 

Necrotizing enterocolitis is a multifactorial pathology with an unspecified pathogenesis. These factors significantly complicate the differential diagnosis, which affects timely therapy and prognosis of the disease. The interstitial protein that binds fatty acids is a specific marker of enterocyte damage; however, the reference values have not yet been clarified. This marker has proven itself in pathologies such as celiac disease, purulent diseases and abdominal trauma, during abdominal operations and other pathologies accompanied by changes in the morphological and histological picture in the intestine. The article presents modern literature data on the diagnostic value of determining the level of protein that binds fatty acids as a marker of damage to enterocytes in necrotizing enterocolitis in children. The value is shown both for differential diagnostics and the prognostic value of an increase in the concentration of the marker in the blood or urine of patients. 

Cryptorchidism is dangerous for possible complications that affect both reproductive health and the state of organs. In patients with bilateral cryptorchidism, infertility as a complication reaches 80%. From a clinical point of view, the most convenient classification of cryptorchidism is its division into cases with palpable and non-palpable testes; clinical tactics is determined by the location and presence of the testicles as such. In about 50% of cases, non-palpable testes are located in the peritoneal cavity, at the inner opening of the inguinal canal, or in the canal itself; in 30% they are atrophic or rudimentary; in 20% of cases, testicular agenesis is observed. Possible causes of testicular absence are agenesis and atrophy after intrauterine torsion. Torsion of an ectopic testicle is extremely rare in pediatric surgery. This clinical example describes torsion, necrosis of an ectopic testicle in order to attract attention, remind pediatric surgeons, urologists, pediatricians of polyclinics, as well as parents of patients about the existence of this disease and the development of alertness, careful observation of children with an undescended testicle, since late diagnosis can to its necrosis. 

The publication contains materials from the satellite symposium «Functional disorders of the gastrointestinal tract in children, current approaches and practical experience», held on February 22, 2020 within the framework of the XXII Congress of Russian Pediatricians with international participation «Actual problems of pediatrics». Functional disorders occupy one of the leading places in the structure of the pathology of the digestive system. The article outlines the latest recommendations of the so-called Rome Consensus 2016 and the criteria for functional disorders; provides new data on their prevalence. The basic provisions concerning functional disorders of the biliary tract are stated. The main clinical signs of functional disorders of the gallbladder and the sphincter of Oddi are presented, confirming the criteria, according to instrumental studies. Therapeutic approaches are discussed. The latest data on the human microbiota and its role in the development of functional diseases in children are also presented. A separate section of the article is devoted to the problem of chronic constipation in children and the role of short-chain fatty acids in the normalization of bowel function. 

Breast milk is ideal nutrition for babies in their first year of life. If breastfeeding is not possible, the child needs to be prescribed an infant formula. The choice of product is based on the health status of the infant. Frequent complaints that a gastroenterologist encounters in everyday practice are associated with gastrointestinal disorders. Functional disorders of the gastrointestinal tract are more often recorded. Timely relief/treatment of gastrointestinal symptoms is extremely important, since the potential benefits of this approach are obvious: prevention of the development of a vicious circle, possible complications and chronicity of the process. The basic strategy for the treatment of gastrointestinal disturbances in infants is nutritional modification, and the empirical product of choice in such situations may be formulas based on partially hydrolyzed protein. The ingredient composition of formula of this category is selected in such a way that conditions are created for the regulation of the gastrointestinal tract. The results of evaluating the clinical tolerance of the formula showed efficacy against colic and functional constipation in children of the first year of life: at the end of the observation period, these disorders were not recorded in children who received this product. 

Irritable bowel syndrome (IBS) is a common pathology in childhood, accompanied by abdominal pain. It is characterized by a long relapsing course, low efficiency of complex therapy. The emergence of a new pathogenetic concept of the «gut-microbiotabrain» axis today made it possible to re-evaluate the mechanism and the onset of the onset of «visceral hypersensitivity», the main key pathogenetic factor in the development of IBS in children. Modern examination methods have made it possible to take a fresh look at the human microbiome, its functions, the role of the microbiota in the pathogenesis of IBS and other painful functional disorders of digestion. The use of probiotic bacteria for medical purposes has a centuries-old history, today their effects are overestimated at a highly indicative level, it is possible to choose the right probiotic strain for a specific clinical situation. The interaction of the gut microbiota and its active metabolites with food components and vitamins leads to a synergistic clinical anti-inflammatory and immune effect aimed at strengthening the intestinal barrier. The use of complex products containing the probiotic strain L. reuteri DSM 17938 with a proven clinical effect in the treatment of abdominal pain in children of different ages, and vitamin D, which has an epithelial and immunotropic effect, allows significantly increase the effectiveness of therapy for IBS in pediatric gastroenterological practice and improve the prognosis of the course of the disease in the future. 

The tolerance, efficacy and safety of use in the nutrition of children from 12 to 36 months, diagnosed with acute respiratory infection, who received antibacterial therapy, were assessed, food/juice drinks enriched with prebiotic, minerals and vitamins for the nutrition of young children. The study included 60 children aged 12 to 36 months diagnosed with acute respiratory infection, who received a course of antibiotic therapy. The children of the main group (30 patients) received, after discharge from the hospital, a juicecontaining drink enriched with inulin, calcium, iron, vitamins C, E, A and D3, 130 ml once a day for 90 ± 1 day (3 months). The comparison group (control) included 30 patients who did not receive this product after discharge. Analysis of the data obtained showed that the daily use of non-adapted fermented milk products for children contributed to the prevention of dyspeptic disorders associated with the intake of antibacterial drugs, comfortable digestion, and an increase in the levels of secretory immunoglobulin A and lysozyme in the feces. Juice drinks enriched with inulin, calcium, iron, vitamins C, E, A and D3 are recommended to be included in the daily diet of healthy children over 12 months old and the diet of children over 12 months old with functional disorders of the gastrointestinal tract (constipation), used in diet therapy for prevention intestinal dysbiosis, in the daily diet of children who are often and for a long time ill, acute period of acute respiratory infections and acute respiratory viral infections, as well as at the stage of convalescence.