Biomedical subjects

Maria Roszkowska-Blaim

Publications and source records attributed to Maria Roszkowska-Blaim.

At least 19 recordsLinked to original sources

PubMed2006

Urological anomalies in children with renal agenesis or multicystic dysplastic kidney.

This study aimed to determine the frequency of associated urological abnormalities in children with unilateral renal agenesis (RA) or multicystic dysplastic kidney (MCDK). In total, 38 children (10 girls, 28 boys) were studied: 21 with RA and 17 with MCDK. In 14 children (37%) anomalies of the urinary tract were suspected prenatally in ultrasound studies. In the remaining 24 children the diagnosis of RA/MCDK was made postnatally: in 13 (34%) in the first 7 days of life, in 11 (29%) at the age of 8 days to 34 months, mean 10.6+/-8.05 months. Voiding cystourethrography was done in 36 (95%) children, the isotopic 99mTc-EC/DMSA scan of the kidney in 29 (67%), and urography in 8. Urological anomalies were present in 11 (29%) children: in 7 (33%) with RA and in 4 (24%) with MCDK. Vesicoureteral reflux was diagnosed in 8 children: grade II in 4, III in 3, and IV in 1 (in 1 child to duplicated, in 1 to ectopic kidney); ureterovesical junction obstruction in 2 (9.5%); and ureteropelvic junction obstruction in 1 (4.8%). Among them, 2 children demanded surgery on the contralateral urinary tract: pyeloplasty in 1, antireflux procedure in 1; while 9 children were treated conservatively. Compensatory hypertrophy of the contralateral kidney was found in 90% of children. Thus due to an increased risk of pathological changes in the single functioning kidney, lifelong nephrological care is recommended in patients with unilateral RA/MCDK.

Child, Preschool↗

PubMed2006

[Influence of obesity in children on kidney].

According to the WHO report the rapid increase of obesity in adults and children is noted in developing and developed countries, resulting the epidemic state. Overweight (obesity) is noted in 50% adults; among children and teens aged 6-19 years, 16% of them are considered as overweight. The adipose tissue is a large endocrine organ secreting biologically active substances as leptin, adiponectin and many growth factors regulating lipids metabolism. Obesity is associated with many complications as: hypertension, dyslipidemia, hyperglycemia (insulin resistance, glomerular hyperperfusion and hyperfiltration resulting renal injury with proteinuria) "obesity related glomerulopathy". The excess body weight in children may be a risk factor for kidney damage.

Child↗

PubMed2006

[Fetuin A in children with renal diseases].

UNLABELLED: Fetuin A, 59 kDa protein, produced in the liver is a circulating inhibitor of vascular calcification. The aim of the study was to estimate a concentration of fetuin A in children with renal diseases. Fifty three children were examined: 18 with idiopathic nephrotic syndrome (NS) aged 2.5 to 14.5 years, mean 6.6 +/- 3.6 and 35 with chronic renal failure (CRF) aged 4.5 to 20 years, mean 13.3 +/- 3.9. The control group (K) consisted of 22 healthy children, aged from 6.5 to 17.5 years, mean 10.8 +/- 3.3. In all children serum concentration of fetuin A (ELISA method, BioVendor), calcium (sCa), phosphorus (sP), protein (P), albumin (Alb), total cholesterol (TC) and triglycerides (TG) were measured. The daily protein excretion in children with proteinuria (mg/kg/day) and the serum parathormone (PTH) level in children with CRF were analysed. RESULTS: The concentration of fetuin A was the lowest in children with NS (78.1 +/- 24.5 ng/ml) and was statistically different (p=0.0003) than in group K (101.4 +/- 11 ng/ml) and group CRF (106.7 +/- 13.7 ng/ml). In group NS significant correlations were found between concentrations of fetuin A and sCa (r=0.62, p<0.01), P (r=0.59, p= 0.01) and Alb (r=0.64, p<0.01) and negative correlations with concentration of TC (r=-0.68, p<0.01) and daily proteinuria (r=-0.79, p<0.001). In groups K and CRF the correlations of fetuin A level and analysed parameters were not found. CONCLUSION: Low concentration of fetuin A in children with nephrotic syndrome may be the additional agent to promote the atherogenic lesions.

Adolescent↗

PubMed2006

[Osteoprotegerin and calcium-phosphorus metabolism parameters in children with chronic renal failure].

UNLABELLED: Osteoprotegerin (OPG), a member of the TNF receptor superfamily is a natural inhibitor of osteoclastogenesis and important inhibitor of vascular calcification. The aim of the study was to estimate a correlation of serum OPG level and the other parameters calcium-phosphorus metabolism in children with chronic renal failure. Seventy four children with chronic renal insufficiency, 48 on conservative treatment (CRF) aged 13 +/- 3 years with creatinine clearance 45 +/- 21 ml/min/1.73m2 and 26 with end-stage renal disease (ESRD) aged 14 +/- 5 years were examined. The control group (K) consisted of 23 healthy children aged 10.8 +/- 3 years. In all children serum concentration of OPG, calcium (sCa), phosphorus (sP), PTH, CAP (cyclase activating PTH), CIP (cyclase inactive PTH) and osteocalcin (OC) were measured. OPG was determined by ELISA method (Biomedica), PTH and OC by IRMA (Duo-PTH, Scantibodies, USA and Osteo-Riact firm CIS, F). RESULTS: The concentration of OPG was higher in ESRD group (3 +/-1.6 pmol/l) than in K (1.95 +/- 0.56 pmol/l), p<0.005. The concentration of OPG in CRF group (2.42 +/- 1.4 pmol/l) was not different from this in K and ESRD. The concentration of OPG did not correlate with serum creatinine level. In CRF group no correlation was found between OPG level and the other parameters, in group ESRD the significant correlation between OPG and OC was found (R=0.55, p=0.006). The level of OPG in children CRF + ESRD correlated with PTH concentration (R=0.27, p<0.03), CAP (R=0.29, p<0.02), CIP (R=0.23, p<0.05) and OC (R=0.25, P<0.04). In patients with higher PTH level (> 200 pg/ml) the higher correlations between OPG and PTH, CAP and CIP were found. No significant correlation between PTH and OPG in patients with lower PTH level (< 200 pg/ ml) was found. No significant correlation between OPG and OC in patients with lower and higher PTH was found. CONCLUSION: The elevated levels of OPG in children with ESRD may reflect the higher bone turnover in these patients.

Adolescent↗

PubMed2006

[Chronic peritoneal dialysis in infants--preliminary results of the multicenter survey].

We retrospectively analysed peritoneal dialysis treatment in 29 infants dialysed in 9 paediatric centres in Poland in the years 1993-2004. The mean age at the start of dialysis was 4.9 +/- 3.5 months (range 2 days to 11 months), mean body mass 5.6 +/- 2.5 kg (range 2.5 to 11 kg). The mean duration of PD was 6.8 +/- 3.9 in the first year of life and total duration of the therapy 34 +/- 27 months. Of the 29 infants 4 died (2 in infancy), 11 underwent renal transplantation, in 2 children PD was stopped (they received a conventional treatment) and 12 were still dialysed at the date of data collection. The peritonitis rate was 1/9.5 patient-month and exit site infection rate 1/16 patient-month up to 1 year of life. 9 children (31%) required hernia repairs and in 9 catheters were replaced. Chronic peritoneal dialysis in infants is associated with high risk of infections and surgical complications and remains a challenge for paediatric nephrologists.

Causality↗

PubMed2006

[Urinary fibronectin excretion as a marker of disease activity in children with IgA nephropathy and Henoch-Schönlein nephropathy].

UNLABELLED: The increase of extracellular matrix proteins synthesis including fibronectin (FN) is associated with development of renal sclerosis. The aim of the study was to examine urinary FN excretion as a marker of renal changes in patients (pts) with IgAN and HSN. The study group consisted of 34 children: IgAN n=11 and HSN n=23, mean age 12.44 +/- 3.83 years. At the onset of illness we observed erytrocyturia in all children, proteinuria in 28: nephrotic sydrome in 14 pts (IgAN--4, HSN--10) and proteinuria in 14 children (IgAN--6, HSN--8). In mean time 0.6 years from the onset of illness renal biopsies were performed. Changes in light microscopy were graded I-V degrees according to the classification of WHO. FN was measured in 24-h urine collections (ng/mg of creatinine), using specific antibody (DAKO) and proteinuria (mg/24h). Mean time from the biopsies to examine FN was 0.76 +/- 1.16 years. FN excretion was analysed in 2 group pts: group A--with proteinuria (n=28); group B--with erytrocyturia (n=6). The control group (K) consisted of 14 healthy children. Renal function was normal in all. RESULTS: The FN concentration higher than normal we observed in 22 pts (78.6%) in group A and 3 (50%) in group B. Mean FN value A was higher (NS) 274 +/- 213.0 than in B 132.0 +/- 68.8 and significant (p<0.01) than in group K (59.9 +/- 31.3). We found a positive correlation between FN and proteinuria in the moment of measurement the FN concentration (p=0.01, r=0.51). The higher values of FN (NS) we observed in pts with higher proteinuria at the onset of illness. FN excretion was significantly eleveted in younger children (p<0.001, r=-0,58). We not found a correlation between mean FN value and the grade of changes in renal biopsies (WHO). CONCLUSION: Urinary FN excretion may be a marker of disease activity in children with IgAN and HSN.

Adolescent↗

PubMed2006

[Birth weight and hypertension (HT) in children with reflux nephropathy (RN)].

UNLABELLED: Low birth weight (bw) has been related to low nephron number and hypertension. Age is an important predictor of developing hypertension in patients with reflux nephropathy (RN). The aim of the study was to assess the relationships between birth weight and blood pressure in children with RN. We investigated 150 patients in mean age 9 +/- 3.3 years with vesicoureteral reflux. In all patients we collected birth weight, we also performed renal scintigraphy (DMSA) and 24-hour ambulatory blood pressure monitoring (ABPM). Standard deviation score body mass index (BMI SDS) was calculated. In ABPM mean value of systolic and diastolic blood pressure (sBP, dBP), blood pressure load during 24 hour and during day and nighttime (LsBP, LdBP) were analyzed. As objective parameters of BP in children in different age and hight, systolic and diastolic BP indices (sBPI, dBPI) were calculated. RESULTS: In analyzed group of children mean bw was 3340 +/- 587 g (from 1300 to 5000 g); in 10 children bw was <2500 g. In 20 children (13%), in 3 with bw <2500 g (30%) and in 17 (12.5%) with normal bw hypertension was diagnosed. The mean age and BMI SDS were lower in children with bw < 2500 g and HT than in children with normal bw and HT (8.2 vs 9.9 years and median -0.53 vs -0.22 respectively). In children with HT mean bw was 3247 +/- 666 g and in children without HT 3293 +/- 461 g (NS). No statistically significant difference was found depends of grades of renal damage in DMSA scan for bw. The negative correlation was found between bw and sBPI, LsBP during 24h and sBPI i LsBP during nighttime (p<0.05 r=-20, p<0.05 r=-19; p<0.05 r=-16, p<0.01 r=-26 respectively). No correlation was found between bw and dBP values. CONCLUSION: In children with RN low bw may be a potential risk factor for developing hypertension independent of severity of renal scarring.

Body Mass Index↗

PubMed2006

[Vesicoureteral reflux in children with prenatal suspicion of urinary tract abnormalities].

AIM: The aim of the study was to assess indications to voiding cystourethrography (VCUG) in children with suspicion of urinary tract (UT) abnormalities in prenatal ultrasonography (US). MATERIAL AND METHODS: We studied 93 children aged 1 day to 7 months (mean 1.4 +/- 1.3 months). Prenatal USG was done between 18-41 week of gestational age (mean 32.6 +/- 5.6). Congenital anomalies of UT were suspected in 88% fetuses with dilatation of UT and in 12% fetuses with other changes in UT. Postnatal US was done in all children between 1-122 day of life (mean 18.2 +/- 21.5); VCUG between 1 day to 13 months (mean 2.1 +/- 2.3 months), in this in 75 (81%) infants in the first months of life. RESULTS: Abnormal result of postnatal US had 84 (90%) children (dilatation of pyelocalyceal system and/or ureter, duplex kidney, multicystic dysplastic kidney, ureterocele). We found normal VCUG in 67 (72%) children, abnormal in 26 (28%). Vesicoureteral reflux (VUR) to 28 kidneys was detected in 20 (21.5%) children (1st--1 kidney, 2nd--14, 3rd--3, 4th--6 and 5th--4 kidneys); another anomalies in 6 (in 2 posterior urethral valves). VUR was observed in 17.3% VCUG performed before 3 months of age and in 38.9% performed later (p<0.05). VUR was recognized: in 17.2% kidneys with normal prenatal US and in 16.4% kidneys with dilatation of UT (NS); in 6 (8%) kidneys with normal postnatal US and 22 (29.8%) with abnormal (p=0.05). There was not statistically significant difference in frequency of VUR in kidney with normal (0-5 mm) and abnormal postnatal renal pelvic diameter (RPD) (11.3% vs 19%, NS). The sensivity and specifity of normal postnatal USG in detection VUR were 79% and 56% respectively, and of normal postnatal RPD were 61% and 46% respectively. CONCLUSIONS: 1. Indication to performing VCUG in children with prenatally detected hydronephrosis should be persistent dilatation of pyelocalyceal system and/or ureter in postnatal US or another abnormalities in UT. 2. Normal prenatal and postnatal USG does not exclude presence of VUR. 3. VCUG in children with prenatally detected hydronephrosis should be performed about 3 months of life, in specially situation earlier.

Causality↗

PubMed2006

[Voiding dysfunction in children with vesicoureteral reflux].

UNLABELLED: The aim of the study was to assess the rate of development of voiding dysfunction (VD) in patients with reflux nephropathy. We investigated 150 pts with vesicoureteral reflux (VUR): 33 boys and 117 girls in mean age 9 +/- 3.3 years with normal renal function. In all pts we performed renal scintigraphy (DMSA) and ABPM. Renal scarring by DMSA scan was categorized into grades 1-4. In all pts we assessed high and laterality of VUR, renal function (clearance creatinine--Ccr) and occurency of hypertension (HT). RESULTS: Of 150 pts, 80 (53.3%) developed VD (54.5% boys and 52% girls). DMSA grade: 1--27 pts, 2--85 pts; 3--31 pts; 4--7 pts. No statistically significant difference was found depends of: sex, age, laterality of renal damage in DMSA, unilateral and bilateral reflux for the development of VD. The incidence 3-4 grade in DMSA scan was significantly higher in pts with IV-V grade of VUR in comparison to pts with lower grade of VUR in group with and without voiding dysfunction. IV-V grades of VUR were observed more frequently in pts with bladder/sphincter dysfunction. The occurency of HT in group with VD and without VD was 12 pts (15%) and 8 (11.4%) respectively (ns). Pts with VD have lower Ccr in comparison with pts without VD (129.1 vs 136.3 ml/min/1.73 m2; p<0.05). CONCLUSIONS: Approximately 50% of patients with VUR demonstrated VD. VD occurred independent of age. IV-V degrees VUR and more severe changes in DMSA scan were seen in pts with bladder/sphincter dysfunction.

Child↗

PubMed2006

[Diagnostic value of PTH total kit for estimation of bone turnover in children with chronic renal failure].

UNLABELLED: The aim of the study was to estimate the usefulness of total PTH and 1-84 molecule (CAP) assay in clinical practice. 118 children with chronic renal failure aged 13.8 +/- 4.5 years were examined: 69 on conservative treatment with creatinine clearance 40.7 +/- 20 ml/min/1.73 m2, 31 on peritoneal dialysis and 16 on hemodialysis. In all patients the following parameters were assessed: serum levels of calcium (sCa), phosphorus (sP), PTH intact (PTHs) by chemiluminescence method (Immulite analyzer), total PTH (PTHc) and CAP with Duo PTH Assay (Scantibodies Laboratories, USA). The value of CIP as the difference between total PTH and CAP was calculated. For the evaluation of bone turnover the serum level of osteocalcin (OC) with IRMA, (OsteoRiact, CIS, F) and activity of serum alkaline phosphatase (AP) were determined. The correlations between parameters were calculated by Pearson's correlation coefficient (r). RESULTS: Significant correlation were found between PTHs and PTHc (r=0.84, p=0.0000), CAP (r=0.79, p=0.0000) and CIP. The increase of PTHs, PTHc, CAP, CIP, sP, OC and percentage of CIP were noticed, when parallel increase of creatinine level was found. The negative correlation between creatinine level and CAP/CIP was observed. The similar correlations between level of PTHs, PTHc, CAP and OC level were observed (r=0.55, 0.49 and 0.50 respectively). CONCLUSION: The assay of total PTH and CAP fragment is not usefull in clinical practice for estimation of bone turnover in children with chronic renal failure.

Adolescent↗

PubMed2006

[The causes of the end of growth hormone treatment in children with chronic renal failure].

UNLABELLED: Growth deficiency is one of complications in chronic renal failure (CRF). In Poland recombinant human growth hormone (rhGH) was introduce to treatment in children with CRF in 1994. The aim of study was to evaluate causes of the end of rhGH treatment in children with CRF. PATIENTS AND METHODS: Among 90 children with different stages of CRF treated with rhGH between 2000-2005 we analyzed 85 patients (33 in CRF and 52 in ESRD), in mean age 9.8 years (from 3 to 17.8 years) which finished therapy. RhGH was used subcutaneously, everyday in doses 1.1 j/kg/week. The anthropometric measurements were performed at the beginning and after one year of the study. RESULTS: The mean time of treatment in 85 children was 18.4 months (1-60 months). The causes of the treatment termination were: renal transplantation in 40 pts (47%), increase of PTH serum level in 13 pts (15.3%), lack of treatment effect in 10pts (11.8%), height achievement at the level of 10c in 10 pts (11.8%), non compliance in 3 pts (3.5%), patient's decision of finishing therapy in 6 pts (7%) and the diagnosis of diabetes during rhGH treatment in 1 pts (1.2%), acute pancreatitis in 1pts (1.2%), epilepsy in 1 pts (1.2%). 25 (29.5%) of out 85 analyzed children had finished the study in the first year. In other 60 patients mean growth velocity was 8.1 cm/year (from 3.3 to 12.4 cm/year). CONCLUSIONS: The main causes of the termination of rhGH treatment in children with CRF were renal transplantation and decompensated secondary hyperparathyroidism.

Adolescent↗

PubMed2006

[Lipids abnormalities in children with refractory nephrotic proteinuria].

UNLABELLED: The aim of the study is to evaluate the lipids disorders in children with refractory proteinuria in acute phase and remission of the disease. The study group consist of 39 children, mean age 8.2 +/- 3.9 years with refractory nephrotic syndrome (RNS)/nephrotic proteinuria (RNP), wchich were divided in 3 groups according to RNS/RNP frequency: group A--17 children up to 3 times, group B--13 children 4-9 times, group C--9 children > or = 10 times. Total number of relapses was 53. In all children at the start and every 3 months, the total cholesterol concentration (TC), LDL, HDL cholesterol, triglicerydes (TG), apolipoprotein A1(apoA1), apoliporotein B100 (apoB100 ) were measured. The duration of the study was 12 months. RESULTS: Children with NS/NP in the acute phase of the disease show high levels of TC, TG, LDL-C and apolipoproteins: apo AI, apo B100, The level of HDL-C was normal. In the groups A, B, C a normalization of average levels of apo B100, was recorded after 3 month, apo AI after 3 to 6 months. With the increasing amount of relapses the time to normalization of average levels of TC and LDL-C was prolonged. Normal average levels of LDL-C were recorded in the group A after 3 months, in the group B after 9 months, in the group C was still high. TC normalization was recorded after 6 months only in the group A, in the groups B and C the level was high; TG was high during 12 months of observation in all groups. CONCLUSION: The persistance of high TC, LDL-C and TG levels during the remission phase in children with higher numbers of NS/NP relapses is a risk factor of atherosclerosis developement.

Apolipoproteins↗

PubMed2005

Does a late referral to a nephrologist constitute a problem in children starting renal replacement therapy in Poland?--a nationwide study.

BACKGROUND: It is estimated that 20-50% of adult patients start chronic dialysis therapy without prior contact with a nephrologist. The aim of this nationwide study was to assess clinical and metabolic status of children at the start of chronic dialysis in Poland with regard to the timing of the referral to a nephrologist. METHODS: We studied data of 180 children (mean age 14+/-6 years) undergoing chronic dialysis in 13 (out of 14) dialysis pediatric centres in Poland. Patients were classified as early referrals (ERs) when they entered the dialysis programme at least 1 month after the first referral to a nephrologist or late referrals (LRs) when the dialysis was introduced within 1 month from the first visit. RESULTS: Seventy-nine percent of pediatric patients were referred early (ER) to the dialysis centre and 21% were referred late (LR) and had to start dialysis within a month. When starting dialysis, LR patients had significantly higher levels of urea and phosphate as well as lower calcium and haemoglobin in comparison with ERs. Hypertension, pulmonary oedema, fluid overload, treatment in the intensive care unit (ICU) and body mass index (BMI) below 10th percentile turned out to be more frequent in the LR group. Peritoneal dialysis (PD) was used as the first method of dialysis in 59% of ERs and 46% of LRs. The majority of ER patients was treated in the predialysis period with calcitriol, phosphate binders and low protein diet (84%, 89%, 92% of all children, respectively), and 20% of them received epoetin. In the up to 3 years observation of our initial cohort, we also found that the patients who were referred late were less likely to receive kidney transplant (P = 0.02). CONCLUSION: The results of the study indicate that the LR to a pediatric nephrologist was associated with poorer clinical and metabolic status of children entering chronic dialysis programmes.

Adolescent↗

PubMed2005

Hypertension in dialysed children: the prevalence and therapeutic approach in Poland--a nationwide survey.

BACKGROUND: The aim of this nationwide analysis was to assess the incidence and current treatment profile of arterial hypertension in children undergoing chronic haemodialysis or peritoneal dialysis and attitudes of paediatric nephrologists towards the choice of antihypertensive drugs in their patients. METHODS: The study group consisted of 134 children (89 males, 45 females, mean age 10.7+/-5 years) from all 13 paediatric dialysis centres in Poland. The data were gathered through a questionnaire for each patient dialysed in November 2004. RESULTS: The overall incidence of hypertension in the study group was 55% (74 of 134 patients; 47 males, 27 females). The incidence rate was similar in boys and girls (53 vs 60%) and in those on haemodialysis and peritoneal dialysis (56 vs 54%). Chronic glomerulonephritis as an underlying renal disease was significantly more frequent in the hypertensive than in the normotensive subjects (37 vs 10%, P = 0.004). Residual urine output was higher in normotensives (41 vs 10 ml/kg body weight; P < 0.001). Among those treated with antihypertensives: 32% were treated by monotherapy, 36% received two drugs, 22% received three drugs, while 7% received > or = 4 drugs. The therapy was effective in only 57% of subjects. We observed no differences in biochemical and clinical parameters between those who responded to the therapy and those who failed to do so. Calcium channel blockers constituted the most frequently administered class of drugs [73% of children; in 43 out of 48 (90%) combined with other drugs, but in 11 out of 24 (46%) as a monotherapy]. In monotherapy, angiotensin-converting enzyme inhibitors and calcium channel blockers were administered most frequently. CONCLUSION: We conclude that the incidence of hypertension in dialysis children in Poland is high (55%). The effectiveness of antihypertensive treatment is rather low (58%) and the choice of drugs is limited.

Adolescent↗

PubMed2005

[Rare causes of interstitial nephritis in two children].

UNLABELLED: Interstitial nephritis (IN) can occur as a result of different injury factors, among them: infections, drugs, toxins. The aim of the study was the presentation of rare causes of IN in 2 patients who were hospitalized in the Department of Pediatrics and Nephrology of Medical University of Warsaw. Case 1. A 15-years-old girl, with biopsy proven IN, who presented with a slight impairment of kidney function (creatinine level 1.1 mg/dl) and symptoms of tubulopathy at the beginning of the illness. Hypergammaglobulinemia, anemia, increase of CRP level and high ESR were noticed. Among others causes CMV infection was suspected. After CMV detection seroconversion in titres of anti- CMV IgM and IgG antibodies was observed. Kidney biopsy revealed IN and positive reaction to CMV antigen in tubular epithelial cells. Case 2. A 12,5-years-old boy with acute renal failure (ARF) (creatinine and urea concentration respectively: 11.3 mg/dl, 131.4 mg/dl) was admitted to the hospital. In kidney biopsy acute IN with tubulopathy and intense involvement of renal tissue was found. In further investigation inhaled stimulating factor was suspected as the possible cause of renal changes development - IN and ARF. CONCLUSION: Considering the etiology of IN in children, CMV infection, the application of drugs and other chemical substances should be mentioned among the rare causes of the illness.

Acute Kidney Injury↗

PubMed2005

[Tubulointerstitial nephritis with uveitis (TINU) syndrome].

Authors present an 11-year old girl with non-specific clinical symptoms with increase of inflammatory indices and acute non-oliguric renal failure: creatinine clearance - 55 ml/min/1.73 m2. An anterior uveitis was observed after 7 weeks of illness. Diagnosis of tubulointerstitial nephritis with uveitis (TINU) was confirmed by interstitial infiltrate (lymphocytes, neutrophils, eosinophils) and interstitial fibrosis in renal biopsy. Steroid therapy was given for 7 months. Uveitis without kidney involvement relapsed 1 month after discontinuation of steroid therapy. The full recovery of uveitis was achieved after the treatment with topical steroids. After 3 years, the illness remains still in remission.

Acute Kidney Injury↗

PubMed2004

Urinary levels of interleukin-6 and interleukin-8 in children with urinary tract infections to age 2.

BACKGROUND: The aim of this study was to assess relations between the clinical course of UTI, IL-6 and IL-8 levels, and the presence of inflammatory changes detected by renal scintigraphy using 99mTc-DMSA (DMSA). MATERIAL/METHODS: We studied 33 children aged 1-24 months (mean 7.1+/-5.8 months) with first-time UTI. The subjects were divided in two groups: with fever (group I, n=10) and without fever (group II, n=23). Inflammatory markers (ESR, CRP, leukocyte count), urinary IL-6 and IL-8 level, and DMSA scan were evaluated in all children. RESULTS: Urinary IL-6 and IL-8 levels [IL-6, IL-8/creatinine (pg/mg)] were significantly higher in group I than in group II (Il-6 level: 39.4+/-41.1 vs. 6.3+/-13.7, p<0.01; IL-8 level: 791.1+/-1143.6 vs. 36+/-87.9, p<0.001). We found positive correlation between urinary IL-6 and IL-8 levels and ESR, CRP, and leukocyte count (IL-6: r=0.43, p<0.05; r=0.46, p<0.05; and r=0.59, p<0.001, respectively; IL-8: r=0.55, p<0.05; r=0.72, p<0.0001; and r=0.44, p<0.05, respectively). We found no relation between urinary cytokine levels and the presence of inflammatory changes detected by DMSA scanning, despite slightly higher mean urinary cytokine levels in children with inflammatory changes in DMSA scan. CONCLUSIONS: We found significantly higher IL-6 and IL-8 levels in children with febrile UTI and elevated inflammatory markers. IL-6 and IL-8 levels do not differentiate between acute pyelonephritis and UTI in children to age 24 months.

Child, Preschool↗

PubMed2002

Growth hormone therapy and lipid profile in children on chronic peritoneal dialysis.

The aim of the study was to assess the effect of recombinant human growth hormone (rhGH) on serum lipids in children treated with chronic peritoneal dialysis. We studied 26 patients aged 5-18 years, including 13 patients treated with rhGH at a dose of 1-1.1 IU/kg per week for 6 months and a control group of 13 patients. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), HDL-C, triglycerides (TG), apolipoproteins A-I and B-100 (apoA and apoB), lipoprotein (a) [Lp(a)], total protein, albumin, urea, and creatinine levels were measured in all children at baseline and at 1, 3, and 6 months of follow-up. We found a significant increase in the TG level after 1 month of administration of rhGH in the treatment group compared with both baseline (218.8+/-49.2 mg/dl vs. 175.9+/-71.9 mg/dl, respectively, P<0.05) and the control group at 1 month of follow-up (146.5+/-44.3 mg/dl, P<0.001). We found no change in TC, LDL-C, HDL-C, apoA, and Lp(a) levels during treatment with rhGH. These data suggest that administration of rhGH to children treated with peritoneal dialysis results in only a transient increase of serum TG level and has no effect on TC, LDL-C, HDL-C, apoA, and Lp(a) levels.

Adolescent↗