Changes of Plasma and Urinary TNF-alpha in Children with Minimal Change Nephrotic Syndrome and Its Role in Albumin Permeability

ABSTRACT

PURPOSE: Minimal Change Disease(MCD) is the most common primary nephrotic syndrome in children. Some suggested that tumor necrosis factor-alpha(TNF-alpha) are involved in the pathogenesis of MCD. This study was done to see the changes of plasma and urinary TNF-alpha, and their effects on the permeability of glomerular basement membrane. METHODS: Study patients consisted of 19 biopsy-proven MCD children aged 2-15 years old. Both plasma and urinary TNF-alpha were measured. Employing the Millicell system, TNF-alpha were screened for the permeability factors. RESULTS: Urinary TNF-alpha during relapse was significantly increased(P<0.01). No significant change was seen in the plasma TNF-alpha during relapse when compared to those in remission and the healthy controls. Furthermore, in the in vitro Millicell system, TNF-alpha did not produce a significant change in albumin permeability. CONCLUSION: Therefore, it seems that TNF-alpha may not play a disease-specific role in the pathogenesis of MCD.