Olgar S, Oktem F, Dindar A, Kilbas A, Turkoglu U D, Cetin H, Altuntas I, Yilmaz R, Uz E, Ertugrul T, Omeroglu R, Aydogan U
Department of Pediatric Cardiology, Istanbul University, Istanbul Faculty of Medicine, Capa, Istanbul, Turkey.
Hum Exp Toxicol. 2008 Jun;27(6):477-83. doi: 10.1177/0960327108092292.
Substance misuse among street children is a significant problem in developing countries. Volatile substances are the most abused agents. According to case reports, chronic renal diseases are common among substance-abusing street children. In this study, we examined the renal findings of 42 volatile substance-abusing street children and compared them with results from 49 healthy children (control). The street children's weight, height, and blood pressure were lower than the controls' (P < 0.05). However, their blood alkaline phosphatase and creatinine phosphokinase levels were higher (P < 0.05), and total blood protein, creatinine, and phosphorus levels were lower than the controls' (P < 0.05). Furthermore, the street children's glomerular filtration rates were within normal limits (P < 0.05), their urinary N-acetyl-beta-glucosaminidase (NAG), beta(2)-microglobulin, microalbumin, protein, calcium, phosphorus, sodium, potassium, and chloride excretions were higher, and tubular phosphate reabsorption were lower than the controls' (P < 0.05). Volatile substances have been charged with causing distal tubular disease, but increased urinary protein, NAG, beta(2)-microglobulin, microalbumin, and electrolyte excretions also result from glomerular, proximal, and distal tubular influences. We believe that increased volatile substance products in the renal parenchyma are responsible for glomerular and tubular damage. Volatile substance-abusing street children should be examined for glomerular and proximal tubular function and distal tubular acidosis.
在发展中国家，街头儿童滥用药物是一个严重问题。挥发性物质是最常被滥用的药物。根据病例报告，慢性肾病在滥用药物的街头儿童中很常见。在本研究中，我们检查了42名滥用挥发性物质的街头儿童的肾脏检查结果，并将其与49名健康儿童（对照组）的结果进行比较。街头儿童的体重、身高和血压低于对照组（P<0.05）。然而，他们的血液碱性磷酸酶和肌酸磷酸激酶水平较高（P<0.05），总血蛋白、肌酐和磷水平低于对照组（P<0.05）。此外，街头儿童的肾小球滤过率在正常范围内（P<0.05），他们的尿N-乙酰-β-氨基葡萄糖苷酶（NAG）、β2-微球蛋白、微量白蛋白、蛋白质、钙、磷、钠、钾和氯排泄较高，肾小管磷酸盐重吸收低于对照组（P<0.05）。挥发性物质被指控导致远端肾小管疾病，但尿蛋白、NAG、β2-微球蛋白、微量白蛋白和电解质排泄增加也源于肾小球、近端和远端肾小管的影响。我们认为肾实质中挥发性物质产物增加是肾小球和肾小管损伤的原因。应对滥用挥发性物质的街头儿童进行肾小球和近端肾小管功能以及远端肾小管酸中毒的检查。
