COMPLEMENT PROTEINS C3, C4 AND NGAL ARE THE FACTORS OF THE SEVERITY OF KIDNEY DAMAGE IN CHILDREN WITH THE HEMOLYTIC-UREMIC SYNDROME
Abstract
The purpose of this study was to determine changes of levels of blood neutrophil gelatinase- associated lipocalin (NGAL), complement proteins C3 and C4 in children with hemolytic-uremic syndrome (HUS) and to find the relationship between them and factors determining the severity of renal damage. A prospective study included 159 children: 35 in the acute phase of HUS, 124 – after HUS, at least 6 months after discharge from the hospital and 28 healthy children. NGAL was elevated in all children with HUS more pronounced in those who required renal replacement therapy. Activation of the alternative pathway of the complement system in HUS D "+" due to reduced C3 and normal C4 levels was found. The degree of increasing NGAL and decreasing complement C3 has a close correlation with parameters reflecting the severity of renal damage.
About the Authors
S. V. BAIKO
Belarusian State Medical University
Belarus
Belarus
A. V. SUKALO
Belarusian State Medical University; Belarusian National Academy of Sciences
Belarus
Belarus
References
1. Ruggenenti, P. Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura / P. Ruggenenti, M. Noris, G. Remuzzi // Kidney Int. – 2001. – Vol. 60, N 3. – P. 831–846.
2. Байко, С. В. Гемолитико-уремический синдром: эпидемиология, классификация, клиника, диагностика, лечение (часть 1) / С. В. Байко // Нефрология и диализ. – 2007. – Т. 9, № 4. – С. 370–377.
3. An international consensus approach to the management of atypical hemolytic uremic syndrome in children / C. Loirat [et al.] // Pediatr. Nephrol. – 2016. – Vol. 31, N 1. – P. 15–39.
4. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury // Kidney Int. Suppl. – 2012. – Vol. 2, N 1. – P. 1–138.
5. Uchino, S. Serum creatinine / S. Uchino // Curr. Opin. Crit. Care. – 2010. – Vol. 16, N 6. – P. 562–567.
6. Isolation and primary structure of NGAL, a novel protein associated with human neutrophil gelatinase / L. Kjeldsen [et al.] // J. Biol. Chem. – 1993. – Vol. 268, N 14. – P. 10425–10432.
7. Kjeidsen, L. Human neutrophil gelatinase-associated lipocalin and homologous proteins in rat and mouse / L. Kjeidsen, J. B. Cowland, N. Borregard // Biochim. Biophys. Acta. – 2000. – Vol. 1482, N 1–2. – P. 272–283.
8. The predictive performance of plasma neutrophil gelatinase-associated lipocalin (NGAL) increases with grade of acute kidney injury / A. Haase-Fielitz [et al.] // Nephrol. Dial. Transplant. – 2009. – Vol. 24, N 11. – P. 3349–3354.
9. Identification of neutrophil gelatinase-associated lipocalin as a novel early biomarker for ischemic renal injury / J. Mishra [et al.] // J. Am. Soc. Nephrol. – 2003. – Vol. 14, N 10. – P. 2534–2543.
10. Cho, H. Complement regulation: physiology and disease relevance / H. Cho // Korean J. Pediatr. – 2015. – Vol. 58, N 7. – P. 239–244.
11. Urinary neutrophil gelatinase-associated lipocalin in D+HUS: a novel marker of renal injury / H. Trachtman [et al.] // Pediatr. Nephrol. – 2006. – Vol. 21, N 7. – P. 989–994.
12. Ohlsson, S. Increased circulating levels of proteinase 3 in patients with anti-neutrophilic cytoplasmic autoantibodiesassociated systemic vasculitis in remission / S. Ohlsson, J. Wieslander, M. Segelmark // Clin. Exp. Immunol. – 2003. – Vol. 131, N 3. – P. 528–535.
13. The complement system in hemolytic-uremic syndrome in childhood / L. Monnens [et al.] // N. Engl. J. Med. – 1980. – Vol. 13, N 4. – P. 168–171.
14. Hypocomplementemia and leukocytosis in diarrhea-associated hemolytic uremic syndrome / W. L. Robson [et al.] // Nephron. – 1992. – Vol. 62, N 3. – P. 296–299.
15. Keir, L. S. Current evidence for the role of complement in the pathogenesis of Shiga toxin haemolytic uraemic syndrome / L. S. Keir, M. A. Saleem // Pediatr. Nephrol. – 2014. – Vol. 29, N 10. – P. 1895–1902.
16. Alternative pathway of complement in children with diarrhea-associated hemolytic uremic syndrome / J. M. Thur- man [et al.] // Clin. J. Am. Soc. Nephrol. – 2009. – Vol. 4, N 12. – P. 1920–1924.
17. Diagnosis of complement alternative pathway disorders / A. Angioi [et al.] // Kidney Int. – 2016. – Vol. 89, N 2. – P. 278–288.
18. Лора, Ш. Атипичный гемолитико-уремический синдром / Ш. Лора, В. Фремю-Бачи // Нефрология. – 2012. – Т. 16, № 2. – C. 16–48.
Review
For citations:
BAIKO S.V., SUKALO A.V. COMPLEMENT PROTEINS C3, C4 AND NGAL ARE THE FACTORS OF THE SEVERITY OF KIDNEY DAMAGE IN CHILDREN WITH THE HEMOLYTIC-UREMIC SYNDROME. Proceedings of the National Academy of Sciences of Belarus, Medical series. 2016;(3):13-19. (In Russ.)
Views: 607
Email this article 