ABSTRACT
Objective To investigate the dynamic changes of neutrophil gelatinase-associated lipoca-lin(NGAL) and kidney injury molecule 1(KIM-1) in children after contrast media administration and evalu-ate the effect of hydration therapy. Methods A total of 58 patients with urinary system diseases who were admitted to Shengjing Hospital of China Medical University from March 2012 to March 2014 for intravenous pyelography(IVP) in pediatric department were enrolled. The 58 patients were randomly divided into hydra-tion group of 28 patients and non-hydration group of 30 patients. Contemporaneous 24 patients received respiratory system enhanced CT examination without urinary tract diseases and hydration were enrolled as control group. Urine NGAL and KIM-1 of the three groups at 0 h,24 h,48 h,72 h,96 h after using intravenous contrast media were detected by ELISA. Serum creatinine of the three groups at 0 h,48 h,96 h after using intravenous contrast media were detected. Results All of the 82 subjects in this study didn′t occur contrast- induced acute kidney injury. The urinary NGAL of non-hydrated group significantly increased at 24 h and 48 h after contrast media administration ( P < 0. 05 ) and the urinary NGAL of hydrated group significantly increased at 48 h and 72 h(P<0. 05). But the urinary NGAL at 24 h and 48 h of the hydration group were lower than these of the non-hydrated group,there were statistically significant differences(P<0. 05). At 24 h,48 h and 72 h after contrast media administration,the level of urine KIM-1 in the non-hydration group sig-nificantly increased(P<0. 05). Urine KIM-1 at 48 h and 72 h in the hydration group significantly increased (P<0. 05). But the urine KIM-1 at 24 h,48 h and 72 h of the hydration group were lower than these of the non-hydration group,the differences were statistically significant(P<0. 05). Comparison of urine NGAL and KIM-1 at different times before and after contrast media administration in children receiving enhanced CT examination who without urinary tract disease showed no statistically significant differences ( P >0. 05 ). Conclusion The urine NGAL and KIM-1 of children with urinary system diseases increase after contrast media administration and there is a trend of spontaneous recovery. Hydration intervention can alleviate the up-ward trend of urine NGAL and KIM-1. For children receiving enhanced CT examination but without urinary system diseases,the change of urine NGAL and KIM-1 are not significant.
ABSTRACT
Objective To evaluate the body burden of Cadmium(Cd) in normal children from Shenyang city,and to analyze the effect of Cd on kidney.Furthermore,to investigate the influences of living factors on the level of Cd in children,so as to make recommendations for children's health.Methods The subjects was composed of 1 170 healthy children recruited from 0 to 17 years old by cluster random sampling method.They were divided into three groups(0-5 years old group,6-11 years old group,12-17 years old group).Questionnaires were used to obtain essential information about age,gender,weight,socioeconomic status,medication,and so on.Second morning urine samples were collected to make routine analyses,urinary Cd(Cdob),urine microalbumin(MALB) and α1-microglobulin(α1-MG).Results 1.A total of 1 070 children including 544 males and 526 females were enrolled.2.The concentration of Cdob increased with age,in agreement with the level of urinary Cd corrected by urine specific gravity (Cdsg).However,the level of Cd in urine corrected by urinary creatinine(Cdcr) presented the opposite status with the age increasing.3.Cdcr and urine MALB adjusted by urinary creatinin(MALBcr) revealed a positive correlation(rs =0.45,P ＜ 0.01).4.Preference values for Cdob and Cdsg,Cdcr respectively were:0-5 years old ＜0.56 μg/L,＜0.83 μg/L and ＜2.17 μg/g Cr;6-11 years old ＜0.65 μg/L,＜1.01 μg/L and ＜1.23 μg/g Cr;12-17 years old ＜0.74 μg/L,＜1.15 μg/L and ＜ 1.25 μg/g Cr.Conclusions There is an age-dependent cumulative increases in Cdob.Although renal damage was not found in this study,the uptake of Cd should be reduced as much as possible and it is necessary to strengthen the follow-up study of Cdob in body burden.