Göknar Nilufer, Oktem Faruk, Arı Engin, Demir Aysegul Doğan, Torun Emel
Department of Pediatric Nephrology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey.
Pediatr Nephrol. 2014 Aug;29(8):1381-6. doi: 10.1007/s00467-014-2773-z. Epub 2014 Feb 14.
Urolithiasis is a common condition in pediatric populations in Turkey. The role of oxidative stress in renal stone formation in pediatric patients has not been reported to date. The aim of this study was to assess oxidative stress in childhood urolithiasis.
Seventy-four children diagnosed with urolithiasis and 72 healthy control subjects were enrolled in the study. Kidney stone formers were evaluated by analysis of metabolic conditions related to urolithiasis, such as hypercalciuria, hyperoxaluria, hypocitraturia and hyperuricosuria. Urine total antioxidant status (TAS), and total oxidant status (TOS) were measured, and oxidative stress index (OSI) was calculated as an indicator of the degree of oxidative stress.
Among the stone formers, metabolic analyses revealed that 30 % had hypercalciuria, 45 % had hypocitraturia, 6 % had hyperoxaluria and 40 % had hyperuricosuria. Elevated levels of the renal tubular damage marker urinary N-acetyl- beta-D-glucosaminidase (NAG) was elevated in 25 % of the patient group, but microalbuminuria was not detected. Total oxidant status and total antioxidant status were significantly higher in stone formers than in the controls (p = 0.023 and 0.004, respectively). In addition, urinary NAG was significantly correlated with TOS (r = 0.427, p = 0.019).
The results of this study show that oxidative stress may play an important role in the pathogenesis of pediatric stone formers.
尿路结石在土耳其儿童群体中是一种常见病症。迄今为止，氧化应激在儿科患者肾结石形成中的作用尚未见报道。本研究旨在评估儿童尿路结石中的氧化应激情况。
74名被诊断为尿路结石的儿童和72名健康对照者纳入本研究。通过分析与尿路结石相关的代谢状况，如高钙尿症、高草酸尿症、低枸橼酸尿症和高尿酸尿症，对肾结石患者进行评估。测量尿液总抗氧化状态（TAS）和总氧化状态（TOS），并计算氧化应激指数（OSI）作为氧化应激程度的指标。
在结石患者中，代谢分析显示30%有高钙尿症，45%有低枸橼酸尿症，6%有高草酸尿症，40%有高尿酸尿症。25%的患者组肾小管损伤标志物尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）水平升高，但未检测到微量白蛋白尿。结石患者的总氧化状态和总抗氧化状态显著高于对照组（分别为p = 0.023和0.004）。此外，尿NAG与TOS显著相关（r = 0.427，p = 0.019）。
本研究结果表明，氧化应激可能在儿科结石患者的发病机制中起重要作用。
