Dalirani Reza, Yousefi Zoshk Mojtaba, Sharifian Mostafa, Mohkam Masoumeh, Karimi Abdollah, Fahimzad Alireza, Varzandefar Mona
Pediatric Infectious Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2011 Sep;5(5):320-3.
The role of vitamin A in re-epithelialization of the damaged mucosal surfaces has been documented. The aim of this study was to evaluate the role of vitamin A in preventing renal scaring after acute pyelonephritis in children.
This clinical trial study was conducted in children with acute pyelonephritis in Mofid Children Hospital (Tehran, Iran). Patients were randomly divided into two groups to receive ceftriaxone and vitamin A or ceftriaxone only. Dimercaptosuccinic acid (DMSA) renal scintigraphy was performed before the start of the treatment and 6 months later. Results were compared for renal scaring between the two groups.
Seventy-six patients (11 boys and 65 girls) were enrolled. The mean age was 25 ± 24 months and 54 patients (71.1%) were under 2 years old. The average vitamin A level was 71 ± 24 microg/dL in the treatment group and it was 62 ± 18 µg/dL in the control group. Baseline DMSA scans were comparable between the two groups in terms of scarring (P = .53), but the second DMSA scans showed a significant change in progression of the renal injury and scaring in the control group compared to those treated with vitamin A as well as antibiotic (P < .001).
We found administration of the vitamin A was useful in decreasing the amount of the injury and scarring following the pyelonephritis. Based on our study, vitamin A can be used in conjunction with other treatments in the management of acute pyelonephritis in children.
维生素A在受损黏膜表面再上皮化过程中的作用已有文献记载。本研究旨在评估维生素A在预防儿童急性肾盂肾炎后肾瘢痕形成中的作用。
本临床试验研究在莫菲德儿童医院（伊朗德黑兰）的急性肾盂肾炎患儿中进行。患者被随机分为两组，分别接受头孢曲松和维生素A或仅接受头孢曲松治疗。在治疗开始前及6个月后进行二巯基丁二酸（DMSA）肾闪烁扫描。比较两组之间肾瘢痕形成的结果。
共纳入76例患者（11例男孩和65例女孩）。平均年龄为25±24个月，54例患者（71.1%）年龄在2岁以下。治疗组的平均维生素A水平为71±24μg/dL，对照组为62±18μg/dL。两组的基线DMSA扫描在瘢痕形成方面具有可比性（P = 0.53），但第二次DMSA扫描显示，与接受维生素A及抗生素治疗的患者相比，对照组的肾损伤进展和瘢痕形成有显著变化（P < 0.001）。
我们发现给予维生素A有助于减少肾盂肾炎后的损伤和瘢痕形成量。基于我们的研究，维生素A可与其他治疗方法联合用于儿童急性肾盂肾炎的治疗。
