THE ROLE OF MOLECULAR MEDICINE IN PREDICTING THE COURSE AND OUTCOME OF CHRONIC PYELONEPHRITIS IN CHILDREN
Keywords:
KIM-1, cystatin C, GFR, chronic pyelonephritis, children, leukocyturia, proteinuria.Abstract
Objective: To determine the level of KIM-1 excretion in urine in groups of patients with chronic pyelonephritis, as well as to assess the possibility of using KIM-1 as a criterion for predicting the clinical course of the disease.
Methods: The study included 43 children aged 7-17 years with chronic pyelonephritis. Depending on the objectives set, a range of clinical, epidemiological, biochemical and statistical methods were used in conducting scientific research.
Results: In patients of group 1 (n-21), edema syndrome of varying severity and localization was observed, proteinuria was 579,0 mg/day with a single dose, hypoalbuminemia, erythrocyturia. In addition, patients in group 1 showed decreased renal function. In group 2 (n-22), daily proteinuria was 282±4.85 mg/day, erythrocyturia did not exceed 5000 in 1 ml according to the Nechiporenko method. The level of KIM-1 in patients of group 1 was 9,59 ng/ml (p <0.001). In patients of group 2, KIM-1 was 1,56 ng/ml.
Conclusions. It has been shown that determination of KIM-1 in urine is an accessible and non-invasive method for early detection of hypoxic, toxic or microbial damage to the renal parenchyma, improving the quality of diagnostics. Another benefit of testing the KIM-1 biomarker in urine is that it reduces the complications, side effects and stress associated with taking blood samples from a child and helps improve the child's quality of life.
References
Alekseev A.V., Gilmanov A.Zh., Gatiyatullina R.S., Rakipov I.G. Modern biomarkers of sharp injury of kidneys. Vestnik Tatarstana Bulletin of Tatarstan, 2014, Vol. 7, no. 583, pp. 22-27. (in Russ).
Akhmedjanova N.I., Akhmedjanov I.A., Ismailova Z.A., Gapparova G.N. Evaluation of Kidney Functioning in Children with Renal Complications During COVID-19 Pandemic: A Retrospective Observational Cohort Clinical Study. Kuban Scientific Medical Bulletin. 2023;30(3):25-33. (In Russ.)
Akhmedzhanova N. I., Akhmedzhanov I. A., Ismailova Z. A., Gapparova G. N. Clinical and laboratory evaluation of renal complications in children during the covid-19 pandemic. Doktor axborotnomasi. 2023;2(110):13-16. (In Russ.)
Vyalkova A. A., Gritsenko V. A., Zykova L. S., L. M. Gordienko1 infection of the urinary system in children in ХХI century. – 2016. – № 2 (14). – pp. 49–56. (In Russ.)
Vyalkova A.A., Gritsenko V.A. Urinary tract infection in children: Current aspects of etiological diagnosis and treatment. Российский вестник перинатологии и педиатрии. – 2017. – Vol. – 62. – № 1. – pp. 99–108. (In Russ.)
Gapparova G. N., Akhmedjanova N. I. Clinical and laboratory characteristics, diagnosis and treatment of pyelonephritis in children during the covid-19 pandemic. 2022. – Vol. 3. – №. 4. pp. 54-57. (in Uzb)
Druzhinina T. Pyelonephritis in children (Lecture). Smolensk Medical Almanac. 2016. №3. URL: https:/ cyberleninka.ru/ articlen/ pielonefrit-u-detey-lektsiya. (In Russ.)
Ignatova M. S. Current issues in pediatric nephrology. Nephrology. 2011. Vol. 15. No. 1. pp. 11-16. (In Russ.)
Margiyeva T. V., Komarova O. V., Vashurina T. V., Kostyushina I. S., Zrobok O. A., Sergeyeva T. V., Tsygin A. N. Recommendations on Diagnosis and Treatment of Urinary Tract Infections in Children. Pediatricheskaya farmakologiya — Pediatric pharmacology. 2016; 13 (1): 17–21. doi: 10.15690/pf. v13i1.1509). (In Russ.)
Boon, H.A. Clinical Features for the Diagnosis of Pediatric Urinary Tract Infections: Systematic Review and Meta-Analysis / H.A. Boon, A. Van den Bruel, T. Struyf [et. al] // Ann Fam Med. 2021. - V. 19(5). - P. 437-446.
Ichimura T., Hung C.C., Yang S.A. et al. Kidney injury molecule-1: a tissue and urinary biomarker for nephrotoxicant-induced renal injury // Am. J. Physiol. Renal Physiol. 2004. Vol. 286. Р. F552–F563
Su H, Yang M, Wan C, Yi LX, Tang F, Zhu HY, Yi F, Yang HC, Fogo AB, Nie X, Zhang C. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int. 2020;98(1):219-227. https://doi.org/10.1016/j.kint.2020.04.003
Schrezenmeier E.V., Barasch J., Budde K., Westhoff T., Schmidt-Ot K.M. Biomarkers in acute kidney injury — pathophysiological basis and clinical performance. Acta Physiol (Oxf). 2017 Mar. № 219(3). Р. 554-572.
Vaidya VS, Ozer JS, Dieterle F, et al. Kidney injury molecule-1 outperforms traditional biomarkers of kidney injury in preclinical biomarker qualification studies. Nat Biotechnol. 2010; 28:478-85. DOI:10.1038/nbt.1623
Wasilewska A, Taranta-Janusz K, Dębek W, ZochZwierz W, Kuroczycka-Saniutycz E. KIM-1 and NGAL: new markers of obstructive nephropathy. Pediatr. Nephrol. Berl. Ger. 2011; 26 (4): 579–586.
Wang K., Xie S., Xiao K. et al. Biomarkers of Sepsis-Induced Acute Kidney Injury. Biomed. Res. Int. 2018. № 24. Р. 6937-6947.
Rizaev JA, Shamsiev JA, Zayniev SS Ways to Optimize Patient Outcomes and Improve the Quality of Medical Care in Surgically Correctable Congenital Malformations in Samarkand //European Journal of Research Development and Sustainability. – 2021. – T. 2. – No. 3. – pp. 45-48.
