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Objective: To determine colour doppler and serum biomarkers spectrum in children with congenital hydronephrosis
Study Design: An observational study
Place and Duration Of Study: Department of Pediatric Nephrology, West China 2nd University Hospital of Sichuan University and Key Laboratory of Birth Defects and Related Disease of Women and Children [Sichuan University], China, from January to December 2017
Methodology: A total of 95 children with hydronephrosis were selected as case group. According to the degree of hydronephrosis, the patients were divided into mild hydronephrosis group, moderate hydronephrosis group, and severe hydronephrosis group. Forty children with normal renal function were selected as normal comparison group. Peak systolic velocity [Vmax], end diastolic velocity [Vmin], resistance index [RI], pulsatility index [PI], and serum cystatin C [CysC], beta2-microglobulin [beta2-MG], and ?1-microglobulin [beta1-MG] of all subjects in both groups were recorded and compared
Results: The Vmax, Vmax of main renal artery [MRA] and interlobar renal artery [IRA] in case group were lower than those of normal group [all p<0.001]. RI of MRA and IRA in case group were higher than those of normal control group [both p<0.001]. There were no significant differences in the PI of MRA and IRA between the two groups [p=0.700, and 0.250 respectively]. The levels of serum CysC, beta2-MG and alpha1-MG in normal control group, mild hydronephrosis group, moderate hydronephrosis group, and severe hydronephrosis group were significantly different [all p<0.001], and the levels of serum CysC, beta2-MG, alpha1-MG were also different in children with different degrees of hydronephrosis
Conclusion: Combined detection of colour doppler and serum biomarkers CysC, beta2-MG and alpha1-MG in the diagnosis of renal damage in congenital hydronephrosis is feasible and reliable
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<p><b>OBJECTIVE</b>This study aimed to investigate the long-term outcomes in children with steroid-resistant nephrotic syndrome (SRNS), who received methylprednisolone pulse therapy (MPT)-based sequential steroid therapy. In particular, we aimed to observe whether these patients had a high risk of adverse events.</p><p><b>METHODS</b>We conducted a retrospective study over a 5-year period. The long-term outcomes for children with SRNS receiving sequential therapy were observed.</p><p><b>RESULTS</b>Sixty-three children were diagnosed with SRNS and underwent MPT-based sequential steroid therapy. Thirty-five (55.6%) achieved complete or partial remission, 19 (30.2%) of whom were in remission even after treatment cessation at last review. The mean time to initial remission after MPT was 24.3±13.1 days. Forty-nine children (77.8%) experienced relapses, of whom 31 (49.2%) demonstrated a frequent relapsing course. Adverse effects relevant to MPT were generally mild and infrequent. Five patients (7.9%) complained of vomiting or nausea during MPT infusion; 25 (39.7%) experienced excessive weight gain and developed an obvious Cushingoid appearance; and 26 (41.3%) had poor growth associated with long-term steroid use. Twenty-eight patients (44.4%) failed to respond to MPT, of whom 21 (33.3%) achieved complete or partial remission with immunosuppressive agents.</p><p><b>CONCLUSION</b>MPT-based sequential steroid therapy appears to be a safe and effective method for inducing rapid remission in childhood SRNS. Further clinical studies are needed to comprehensively evaluate this therapy.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Drug Resistance , Methylprednisolone , Nephrotic Syndrome , Drug Therapy , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
Objective To explore the expression and the role of Toll-like receptor(TLR3 and TLR4) in rats with nephrotic syndrome induced by respiratory syncytial virus(RSV).Methods SD rats were inoculated intranasally and intraperitoneally with 6?106 plaque for-ming unit(PFU) RSV to construct RSV-induced nephropathy in rat model.Rats were anesthetized and blood was withdrawn from cardiac on day 4,14,30,60 after inoculation.The normal ones without intervention were set as control group.The renal histology was observed by light microscope and electron microscope.The urinary protein collected in 24 hours were measured.Meanwhile,the expressions of TLR3 and TLR4 were detected by indirect immunofluorescence staining and flow cytometry in peripheral blood mononuclear cells of rats.The results were analyzed by SPSS 13.0 softwore.Results After inoculation,the proteinuria increased and under the electron microscope the foot processes of glomerular epithelial cells were fused which resembled human minimal change nephrotic syndrome.Proteinuria reached the peak and the fusion of foot processes were most extensive in rats of RSV at 60 d.The expressions of TLR3 and TLR4 in each group of RSV-induced nephropathy in rat models were significantly higher than those in normal control group(Pa0.05).Conclusions TLR3 and TLR4 in peripheral blood mononuclear cells of RSV-induced nephropathy rat mo-dels had being significantly activated until 60 d after RSV inoculation.TLR signaling pathway may play an important role in nephrotic syndrome of rats induced by RSV.
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0.05).3.Under light microscope, there was no change of the glomeruli detected in all of the LMWH-treated groups compared with the controls,while congestion and swel-ling in part glomeruli of group RSV were observed significantly. 4.Under electron microscope,glomerular structures of the LMWH-treated groups were almost normal compared with the control, while extensive foot process effacement was observed in group RSV under an electron microscope. 5.RSV RNA signal expressed weaker in the LMWH-treated groups than in group RSV.Conclusions Positive charged RSV destroys the glome-rular filtration barrier through its electrostatic interaction with the negative charged heparan sulfate(HS) of GBM. LMWH, as the analog of HS, charged with anion, competes with GBM HS to combine with RSV to keep the glomeruli from being infected and destroyed, and then reduce the proteinuria.