ESPN 51th Annual Meeting

ESPN 2018


 
EARLY MARKERS OF THE PROGRESSION OF REFLUX NEPHROPATHY IN CHILDREN
NATALIA ZAIKOVA 1 VLADIMIR DLIN 2 LILIA SINITCINA 1 ANATOLII KORSUNSKII 3 NELLI REVENCO 1

1- INSTITUTION OF MOTHER AND CHILD CARE
2- DEPARTMENT OF PEDIATRICS AND COMMUNICABLE DISEASES, I.M. SECHENOV FIRST MOSCOW STATE MEDICAL UNIVERSITY
3- PIROGOV RUSSIAN NATIONAL RESEARCH MEDICAL UNIVERSITY
 
Introduction:

 The determination of urinary excretion of TGF-β1 and Ang II,β2-MG in children with VUR for early detection and prediction of reflux nephropathy progression.  

Material and methods:

79 patients with different degree of VUR in age 1 - 14 years (average age of 5.69±0.44 years), including 58 girls (73.4%). Based on the results of renal DMSA-scintigraphy the patients were divided into the following groups: compared group (group 1) – patients with different degree of VUR without RN (n= 12, mean age of 1.65± 0.31 years) - 8 girls (88.9%). The main group (group 2): patients with different degree of VUR with RN (n= 67, mean age of 5,88±0,54 y) - 50 g (74.6%). Control group - 20 healthy children (6.24±0.31 y) - 12 g (60%). The studied group of patients did not differ significantly by gender and age in comparison with controls. In all children investigated the urinary excretion of Ang II, TGF-β1, β2-MG and counted it to the level of creatinine in the urine. 

Results:

 Urinary levels of Ang II, TGF-β1, β2-MG was significantly higher in groups of children with RN when compared with the control group. The high level of Ang II, TGF-β1 was determined in the main group compared with the comparison group (p<0.05). The most significant markers for early detection of RN were AngII and TGF-β1, the level of GFR and β2-MG - markers of progression of RN. Reduction of GFR is an unfavorable symptom of the course of RN and characteristic feature for severe RN and its progressive course. 

Conclusions:

 The established direct correlation between the level of excretion of the studied pro-fibrogenic factors and the development of RN indicates the feasibility and prospects of their inclusion as diagnostic markers for the early detection of reflux-nephropathy. The urinary level of β2-MG is more reflective of the progressing course of reflux-nephropathy.