Prospective Study on Several Urinary Biomarkers as Indicators of Renal Damage in Children with CAKUT

Purpose The aim of the study was to investigate urinary levels of monocyte chemotactic protein-1 (MCP-1), epidermal growth factor (EGF), β-2-microglobulin (β2M), and FAS-ligand (FAS-L) in children with congenital anomalies of kidney and urinary tract (CAKUT) disease at risk of developing glomerular hyperfiltration syndrome. For this reason, we selected patients with multicystic kidney, renal agenesia and renal hypodysplasia, or underwent single nephrectomy. Materials and Methods This prospective, multicentric study was conducted in collaboration between the Pediatric Surgery Unit in Foggia and the Pediatric Nephrology Unit in Bari, Italy. We enrolled 80 children with CAKUT (40 hypodysplasia, 22 agenetic; 10 multicystic; 8 nephrectomy) who underwent extensive urological and nephrological workup. Exclusion criteria were recent urinary tract infections or pyelonephritis, age > 14 years, presence of systemic disease, or hypertension. A single urine sample was collected in a noninvasive way and processed for measuring by enzyme-linked immunosorbent assay urine levels of MCP-1, EGF, β2M, and FAS-L. As control, urine samples were taken from 30 healthy children.Furthermore, we evaluated the urinary ratios uEGF/uMCP-1 (indicator of regenerative vs inflammatory response) and uEGF/uβ2M (indicator of regenerative response vs. tubular damage). Results These results suggest that urinary levels of MCP-1 are overexpressed in CAKUT patients. Furthermore, our findings clearly demonstrated that both uEGF/uMCP-1 and uEGF/uβ2M ratios were significantly downregulated in all patient groups when compared with the control group. Conclusion These findings further support that CAKUT patients may, eventually, experience progressive renal damage and poor regenerative response. The increased urinary levels of MCP-1 in all groups of CAKUT patients suggested that the main factor responsible for the above effects is chronic renal inflammation mediated by local monocytes.

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Endogenous Proteins in Infants and Toddlers with Urinary Tract Infections

Doctor Ru ◽

10.31550/1727-2378-2021-20-10-44-47 ◽

2021 ◽

Vol 20 (10) ◽

pp. 44-47

Author(s):

A.N. Ni ◽

◽

T.A. Shumatova ◽

E.V. Sergeeva ◽

N.G. Prikhodchenko ◽

...

Keyword(s):

Fatty Acid ◽

Urinary Tract ◽

Membrane Permeability ◽

Urinary Tract Infections ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Children ◽

Infants And Toddlers ◽

Fatty Acid Binding ◽

Endogenous Proteins ◽

Tract Infections

Study Objective: To find the diagnostic and pathogenetic significance of endogenous proteins in infants and toddlers with urinary tract infections (UTIs). Study Design: controlled clinical trial. Materials and Methods. We examined 34 children with UTIs aged 29 days to 2 years 11 months and 29 days. The control group included 20 healthy children. All subjects underwent measurement of serum hepatic and intestinal fatty acid-binding proteins (L-FABP, I-FABP), bacterial membrane permeability-increasing protein (BPI), as well as urinary I-FABP and zonulin using the enzyme-linked immunosorbent assay (ELISA) method. Study Results. Children with UTIs demonstrated significantly increased L-FABP and I-FABP levels vs. controls (798.89 ± 171.69 ng/mL vs. 175.86 ± 23.07 ng/mL; 92.37 ± 18.53 ng/mL vs. 19.21 ± 4.94 ng/mL, respectively, р < 0.05). BPI levels were also significantly higher (105.03 ± 38.18 ng/mL) in children with UTIs (р < 0.05). Urinary I-FABP concentration was significantly different from that in healthy children (0.11 ± 0.04 pg/mL vs. 0.039 ± 0.009 pg/mL, р < 0.05). Zonulin levels were also higher (3.15 ± 0.64 ng/mL vs. 0.12 ± 0.04 ng/mL, р < 0.01). Conclusion. The study allowed clarifying the pathogenic significance of increased intestine permeability in development of inflammations and identifying early markers of kidney nd urinary tract damages (L-FABP, I-FABP, BPI). Increased urinary I-FABP and zonulin levels can predict UTIs in infants and toddlers. Keywords: fatty acid-binding protein, membrane permeability-increasing protein, urinary tract infections.

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Cytokine Profiles of Pediatric Patients Treated with Antibiotics for Pyelonephritis: Potential Therapeutic Impact

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.8.6.1060-1063.2001 ◽

2001 ◽

Vol 8 (6) ◽

pp. 1060-1063 ◽

Cited By ~ 24

Author(s):

Kari Kassir ◽

Ofelia Vargas-Shiraishi ◽

Frank Zaldivar ◽

Monique Berman ◽

Jasjit Singh ◽

...

Keyword(s):

Urinary Tract ◽

Renal Scarring ◽

Infants And Children ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Children ◽

Systemic Involvement ◽

Reactive Protein ◽

Tract Infections ◽

In Infants And Children

ABSTRACT Urinary tract infections are common in infants and children. Pyelonephritis may result in serious complications, such as renal scarring, hypertension, and renal failure. Identification of the timing of release of inflammatory cytokines in relation to pyelonephritis and its treatment is essential for designing interventions that would minimize tissue damage. To this end, we measured urinary cytokine concentrations of interleukin-1β (IL-1β), IL-6, and IL-8 in infants and children with pyelonephritis and in healthy children. Children that presented to our institution with presumed urinary tract infection were given the diagnosis of pyelonephritis if they had a positive urine culture, pyuria, and one or more of the following indicators of systemic involvement: fever, elevated peripheral white blood cell count, or elevated C-reactive protein. Urine samples were obtained at the time of presentation prior to the administration of antibiotics, immediately after completion of the first dose of antibiotics, and at follow up 12 to 24 h after presentation. IL-1β, IL-6, and IL-8 concentrations were measured by enzyme-linked immunosorbent assay. Creatinine concentrations were also determined, and cytokine/creatinine ratios were calculated to standardize samples. Differences between preantibiotic and follow-up cytokine/creatinine ratios were significant for IL-1β, IL-6, and IL-8 (P < 0.01). Differences between preantibiotic and control cytokine/creatinine ratios were also significant for IL-1β, IL-6, and IL-8 (P < 0.01). Our study revealed that the urinary tract cytokine response to infection is intense but dissipates shortly after the initiation of antibiotic treatment. This suggests that renal damage due to inflammation begins early in infection, underscoring the need for rapid diagnosis and intervention.

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The Role of TLR4 Asp299Gly and TLR4 Thr399Ile Polymorphisms in the Pathogenesis of Urinary Tract Infections: First Evaluation in Infants and Children of Greek Origin

Journal of Immunology Research ◽

10.1155/2019/6503832 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Panagiota Karananou ◽

Despoina Tramma ◽

Socrates Katafigiotis ◽

Anastasia Alataki ◽

Alexandros Lambropoulos ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Bacterial Infections ◽

Pediatric Population ◽

Infants And Children ◽

Healthy Children ◽

Healthy Infants ◽

Tract Infections ◽

In Infants And Children

Urinary tract infections are one of the most common and serious bacterial infections in a pediatric population. So far, they have mainly been related to age, gender, ethnicity, socioeconomic level, and the presence of underlying anatomical or functional, congenital, or acquired abnormalities. Recently, both innate and adaptive immunities and their interaction in the pathogenesis and the development of UTIs have been studied. The aim of this study was to assess the role and the effect of the two most frequent polymorphisms of TLR4 Asp299Gly and Thr399Ile on the development of UTIs in infants and children of Greek origin. We studied 51 infants and children with at least one episode of acute urinary tract infection and 109 healthy infants and children. We found that 27.5% of patients and 8.26% of healthy children carried the heterozygote genotype for TLR4 Asp299Gly. TLR4 Thr399Ile polymorphism was found to be higher in healthy children and lower in the patient group. No homozygosity for both studied polymorphisms was detected in our patients. In the group of healthy children, a homozygote genotype for TLR4 Asp299Gly (G/G) as well as for TLR4 Thr399Ile (T/T) was showed (1.84% and 0.92 respectively). These results indicate the role of TLR4 polymorphism as a genetic risk for the development of UTIs in infants and children of Greek origin.

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Urinary Tract Infections and Renal Damage

JAMA Pediatrics ◽

10.1001/jamapediatrics.2014.1329 ◽

2014 ◽

Vol 168 (10) ◽

pp. 884 ◽

Cited By ~ 1

Author(s):

Kenneth B. Roberts

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Renal Damage ◽

Tract Infections

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Evaluation of Serum and Urinary Levels of some Pteridine Pathway Components in Healthy Turkish Children

Pteridines ◽

10.1515/pteridines.2012.23.1.90 ◽

2012 ◽

Vol 23 (1) ◽

pp. 90-95 ◽

Cited By ~ 2

Author(s):

Gözde Girgin ◽

Terken Baydar ◽

Dietmar Fuchs ◽

Gönül Sahin ◽

Elif Özmert ◽

...

Keyword(s):

Survival Data ◽

Normal Values ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Children ◽

Guanosine Triphosphate ◽

Turkish Children ◽

Urinary Levels ◽

Urinary Neopterin ◽

Cellular Immune ◽

Serum And Urine

Abstract Neopterin, as a non-conjugated pteridine, is synthesized from guanosine triphosphate and its production is upregulated upon the activation of cellular immune response. Alterations of pteridines in body fluids are known to correlate well with existing diseases and stages, prognosis, clinical outcomes and survival data. It is of advantage to have a pteridine database of healthy volunteers to determine normal values. Thereby, especially in children there is no detailed study on pteridine levels. The aim of this study is to initiate the establishment of pteridine database of healthy children in our country. Serum neopterin levels were analysed by enzyme-linked immunosorbent assay. Urinary neopterin and biopterin levels and serum kynurenine, tryptophan levels and kynurenine/tryptophan ratio as an estimate of tryptophan breakdown were assessed with high-pressure liquid chromatography in serum and urine samples of 55 children aged between 3 months and 10 years. The results were evaluated within the subgroups of different ages and sex. Pteridine pathway components were found to be higher in children compared to adults. Higher levels of pteridine pathway components observed within the first years of life may reflect the rapid maturation of the immune system, and environmental adaptation and/or insufficiency of defence systems. On the other hand, it may also relate to a higher frequency of infections not (yet) manifested clinically.

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Uropol for urinary infections

Drug and Therapeutics Bulletin ◽

10.1136/dtb.8.1.3 ◽

1970 ◽

Vol 8 (1) ◽

pp. 3-4

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract ◽

Bacterial Resistance ◽

Mixed Infections ◽

Drug Excretion ◽

Urinary Infections ◽

Bright Orange ◽

Urinary Levels ◽

Tract Infections ◽

Lower Urinary

Uropol (Bristol Labs) is a combination of tetracycline phosphate complex, sulphamethizole and phenazopyridine for use in acute and chronic urinary tract infections. The makers claim that it gives therapeutic tissue levels of tetracycline and high urinary levels of sulphonamide, and so reduces the risk of bacterial resistance developing, and that it is useful in the treatment of mixed infections. The addition of phenazopyridine is claimed to provide local analgesia in the lower urinary tract as well as visual assurance of drug excretion by colouring the urine bright orange-red.

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Urinary tract infection

Paediatric Nephrology ◽

10.1093/med/9780198784272.003.0004 ◽

2019 ◽

pp. 87-102

Author(s):

Lesley Rees ◽

Nicholas J.A Webb ◽

Detlef Bockenhauer ◽

Marilynn G. Punaro

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Renal Damage ◽

Renal Abnormality ◽

Its Analysis ◽

Tract Infections

Urinary tract infections are important because they may be caused by a structural renal abnormality, diagnosis of which may prevent further renal damage. The importance of collection of the sample and its analysis is vital to prevent unnecessary invasive investigations.

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AUTOANTIBODIES TO TAMM-HORSFALL GLYCOPROTEIN IN CHILDREN WITH RENAL DAMAGE ASSOCIATED WITH URINARY TRACT INFECTIONS

Acta Paediatrica ◽

10.1111/j.1651-2227.1980.tb07138.x ◽

1980 ◽

Vol 69 (6) ◽

pp. 709-715 ◽

Cited By ~ 12

Author(s):

A. FASTH ◽

J. BJURE ◽

M. HELLSTRÖM ◽

B. JACOBSSON ◽

U. JODAL

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Renal Damage ◽

Tract Infections

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Comparison of DMSA Scintigraphy and USG in Detecting Renal Cortical Scars in Children with Urinary Tract Infection

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1642595 ◽

2018 ◽

Vol 13 (03) ◽

pp. 210-215

Author(s):

Fatma Taşbent ◽

Özlem Şahin

Keyword(s):

Urinary Tract ◽

Predictive Value ◽

Renal Damage ◽

Renal Scarring ◽

Imaging Techniques ◽

Dmsa Scintigraphy ◽

Multiple Imaging ◽

Tract Infections ◽

Sensitivity Specificity ◽

Parenchymal Damage

Objective Multiple imaging techniques may be used to evaluate the development of progressive renal damage in children with urinary tract infections (UTIs). The aim of this study was to compare the efficacy of Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy and renal ultrasonography (USG) in detecting renal scars in children with UTIs. Methods A total of 630 kidneys from 364 children were included in the study and the results of DMSA and USG of children with UTIs were evaluated retrospectively between January 2016 and October 2017. DMSA scintigraphy is accepted as the gold standard and it was compared with USG results. Results The sensitivity, specificity, positive predictive value, and negative predictive value for USG in the detection of renal scarring was found as 57.1, 89.6, 40.8, and 94.4%, respectively. Conclusions Although USG is known to be safe, readily available, and relatively inexpensive, the sensitivity of USG does not seem to be sufficient to identify the renal parenchymal damage. We concluded that USG cannot replace DMSA in the evaluation of renal scarring.

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