Wasilewska Anna, Taranta-Janusz Katarzyna, Zoch-Zwierz Walentyna, Michaluk-Skutnik Joanna
Department of Paediatrics and Nephrology, Medical University of Białystok, Białystok, Poland.
Scand J Urol Nephrol. 2012 Feb;46(1):58-64. doi: 10.3109/00365599.2011.630013. Epub 2011 Oct 24.
The purpose of this cross-sectional study was to identify whether plasma symmetric dimethylarginine (pSDMA) is a useful marker of renal function in children.
The study group consisted of 35 patients with chronic kidney disease (CKD) stages 1-5 (median age 11.5 years), classified on the basis of estimated glomerular filtration rate (eGFR) and divided into three groups: group A, patients with CKD stages 1 and 2; group B, CKD stage 3; and group C, CKD stages 4 and 5. A control group included 42 age-matched healthy children. Commercial enzyme-linked immunosorbent assay kits were used to measure pSDMA and serum cystatin C (sCysC) concentrations.
The pSDMA and sCysC levels were significantly elevated in all CKD patients in comparison with healthy controls (p < 0.05). The pSDMA level in children was increased in the mild CKD (group A) (p < 0.01). There were also a significant difference in pSDMA concentration between groups A and B (p < 0.01). No differences in pSDMA levels were found between groups B and C. Receiver operating characteristics analyses showed that pSDMA was a better diagnostic tool than sCysC for identifying CKD stage among all the examined children and for detecting patients from group A (eGFR >60 ml/min/1.73 m(2)).
Increased pSDMA and sCysC levels were found in CKD children. Further studies are required to confirm potential applications of pSDMA and CysC as useful biomarkers for the diagnosis and progression of CKD.
本横断面研究的目的是确定血浆对称二甲基精氨酸（pSDMA）是否为儿童肾功能的有用标志物。
研究组由35例慢性肾脏病（CKD）1 - 5期患者（中位年龄11.5岁）组成，根据估计肾小球滤过率（eGFR）分类并分为三组：A组，CKD 1期和2期患者；B组，CKD 3期；C组，CKD 4期和5期。对照组包括42名年龄匹配的健康儿童。使用商用酶联免疫吸附测定试剂盒测量pSDMA和血清胱抑素C（sCysC）浓度。
与健康对照组相比，所有CKD患者的pSDMA和sCysC水平均显著升高（p < 0.05）。轻度CKD（A组）儿童的pSDMA水平升高（p < 0.01）。A组和B组之间的pSDMA浓度也存在显著差异（p < 0.01）。B组和C组之间未发现pSDMA水平有差异。受试者工作特征分析表明，在所有检查的儿童中，对于识别CKD分期以及检测A组（eGFR > 60 ml/min/1.73 m²）患者，pSDMA是比sCysC更好的诊断工具。
在CKD儿童中发现pSDMA和sCysC水平升高。需要进一步研究以确认pSDMA和CysC作为CKD诊断和进展的有用生物标志物的潜在应用。
