Distinction of Degrees of Ischemic Kidney Parenchymal Injury in Children with Congenital Vesicoureteral Reflux (According to Enzymological Criteria)
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
The objective: to evaluate the possibility of determining the levels of activity of N-acetyl-β-D-glucosaminidase B (NAG B) in urine as an enzymological marker of differentiation of ischemic damage to the renal parenchyma in children with congenital vesicoureteral reflux (VUR).
Materials and methods. 49 children aged 1 to 15 years with a verified diagnosis of unilateral VUR and 25 practically healthy children were examined. NAG B activity in urine was determined before reconstructive treatment. The limits of the reference intervals of the levels of enzyme activity in the urine of healthy children were calculated by the formula M±1.5σ.
According to the personalized analysis the patientswere divided into 3 groups: group 1 – 13 patients (the levels of NAG activity in the urine are registered from 0.8 to 2.3 units); group 2 – 14 patients (the levels of NAG activity in the urine – 2.4 to 4.5 units); group 3 – 22 patients (the levels of NAG activity in urine – 4.6 to 10.5 units.
Results. In the urine of healthy children, the activity of NAG B averages 1.56±0.096 units, σ=0.48, reference levels are recorded from 0.8 to 2.3 units. In the urine of the 1st group, the levels of NAG B activity are equal to 1.61±0.13 units correspond to the control values and are evaluated as zero degree of ischemic damage of a renal parenchyma; in the urine of the 2nd group – 3.97±0.17 units exceed the average control values by 1.6–2.9 times and are assessed as moderate or I degree of ischemic damage to the renal parenchyma; in the urine of the 3rd group – 7.50±0.39 units exceed the average control values by 3 times or more and are assessed as severe or II degree of ischemic damage to the renal parenchyma (p2,3-1<0,001; p3-2<0.001).
Conclusions. The expediency of determining the activity levels of N-acetyl-β-D-glucosaminidase B in the urine of children with congenital vesicoureteral reflux, as an enzyme with pronounced renospecific properties and as enzyme marker for differentiating the degrees of ischemic damage (0, I, II) of the renal parenchyma was established. Activity levels of NAG B can be used as well for timely prevention of the development and progression severe complications through the timely appointment of the appropriate optimal corrective therapy.
##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Kalishchuk OA. Endoskopichne likuvannya mikhurovo-sechovidnoho reflyuksa u ditey z neyrohennymy dysfunktsiyamy sechovoho mikhura [avtreferat]. Kyiv: Instytut urolohiyi AMN Ukrayiny; 2006. 20 p.
Zorkyn SN, Khvorostov YN, Smyrnov YE, Dvoryakovskyy YV, Skutyna LE. Patohenetycheskye osnovy formyrovaniya i pryntsypy lecheniya obstruktyvnykh uropatyy u detey. Visnyk Vinnyts’koho Nats. universytetu. 2007;11(1/1):198–204.
Chugunova OL, Dumova SV, Verbitskiy VI, Melekhina YEV, Tabolin VA. Sovremenniye metody lecheniya detey pervykh let zhizni s zabolevaniyami organov mochevoy sistemy. Vestnik pediatr farmakol i nutritsiol. 2006;3(2):18–23.
Babayeva NI, Lipitskaya ND, Tvorogova VN. Titov Diagnosticheskoye znacheniye issledovaniya aktivnosti N-atsetil-b-D-glyukozaminidazy v moche (obzor literatury). Labor delo. 1991;(1):9–16.
Mohkam M, Ghafari A. The Role of Urinary N-acetyl-beta-glucosaminidase in Diagnosis of Kidney Diseases. Ped Nephrol. 2015;3(3):84–91.
Melnik AA. Diagnosticheskaya rol N-atsetil-b-D-glyukozaminidazy kak rannego markera povrezhdeniya pochek. Nirki. 2016;(4):37–47.
Nikulina HH, Peterburhskyy VF, Myhal LYA, Serbina IYE, Kalishchuk OA, vynakhidnyky; Derzhavna ustanova Instytut urolohiyi NAMN Ukrayiny, patentovlasnyk. Sposib prohnozuvannya efektyvnosti rekonstruktyvnoho likuvannya ditey z vrodzhenym mikhurovo-sechovidnym reflyuksom. Patent Ukrayiny № 123808. 2021 Lyp 02.
Multbery B, Isaksson А. Enzyme immunoassay of β-hexosaminidase isoenzymes in human urine and renal cortex with monoclonal antibodies. Enzyme. 1989;42(1):25–30. doi: 10.1159/000469003.
Williams MA, Jones D, Noe HN. Urinary N-acetyl-beta-glucosaminidase as a screening technique for vesicoureteral reflux. J Urol. 1994;43(4):528–30. doi: 10.1016/0090-4295(94)90248-8.
Vozianov SO, Chernenko VV, Nikulina HH, Myhal LYA, Zheltovska NI, Chernenko DV, ta in. Enzymolohichni indykatory ishemichnoho ushkodzhennya parenkhimy nyrky u khvorykh na sechokamyanu khvorobu (Kliniko-eksperymentalne doslidzhennya). Zdorovya cholovika. 2020;(3):42–5.
Kraydashenko OV, Dolinna MO. Biomarkery poshkodzhennya nyrok u khvorykh na hipertonichnu khvorobu. Ukr zhurn nefrolo ta dializu. 2014;3(43):48–51.
Borysov SO. Patohenetychna rol fermentatyvnoyi aktyvnosti N-atsetyl-b-D-hlyukozaminidazy u monitorynhu farmakokorektsiyi pry hostromu piyelonefryti, uskladnenomu tsukrovym diabetom v eksperymenti. Urol. 2020;24,4(95):344–53.
Maydannik VG, Murenko AI. Informativnost sovremennykh markerov diabeticheskoy nefropatii u detey. Mezhdunar zhurn pediatr akusherstva i ginekol. 2014;5(3):55–68.
Bachurin HV, Kolomoyets YUS. Diahnostychno-prohnostychna rol tsytokiniv, interleykiniv ta biomarkeriv rannyoho poshkodzhennya nyrok u khvorykh na sechokamyanu khvorobu. Urol. 2019;23,3(90):237–42.
Vlasov VV. Effektivnost’ diagnosticheskikh issledovaniy. Moskva: Meditsina; 1988. 180 p.
Myhal LYA. Nikulina HH, Serbina IYE, Seymivskyy DA, Peterburhs’kyy VF. Diahnostychna informatyvnist enzymolohichnykh pokaznykiv lizosomnoho pokhodzhennya u sechi ditey z vrodzhenoyu obstruktsiyeyu verkhnikh sechovykh shlyakhiv. Lab diahnostyka. 2012;61(3):15–9.
Peterburhskyy VF, Myhal LYA, Nikulina HH, Serbina IYE, Kalishchuk OA. Osoblyvosti zmin renospetsyfichnykh enzymiv sechi u ditey z vrodzhenym mikhurovo-sechovidnym reflyuksom zalezhno vid yoho stupenya. V: Material online nauk-prakt koef Urolohiya, androlohiya, nefrolohiya – dosyahnennya, problemy, shlyakhy vyrishennya; 2021 Ver 09-10; Kharkiv. Kharkiv: KHNMU; 2021, p. 273–6.
