Demir Ayşegül Doğan, Goknar Nilufer, Oktem Faruk, Özkaya Emin, Yazıcı Mebrure, Torun Emel, Vehapoğlu Aysel, Kucukkoc Mehmet
Bezmialem Vakif University, Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey
Bezmialem Vakif University, Faculty of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey.
Int J Immunopathol Pharmacol. 2016 Dec;29(4):626-631. doi: 10.1177/0394632016651448. Epub 2016 Jun 7.
Asthma is a chronic inflammatory disorder of the airways which results in chronic hypoxia. Chronic hypoxia and inflammation can affect renal tubular function.
The aim of this study was to investigate renal tubular function and early kidney injury molecules such as urinary N-acetyl-betaglucosaminidase (NAG) and kidney injury molecule-1 (KIM-1) excretion in children with asthma.
Enrolled in the study were 73 children diagnosed with asthma and 65 healthy age- and gender-matched control subjects. Urine pH, sodium, phosphorus, potassium, microalbumin, creatinine, NAG, KIM-1, and serum creatinine, sodium, phosphorus were evaluated. The diagnosis of asthma and classification of mild or moderate were done according to the Global Initiative for Asthma guidelines.
Serum sodium, phosphorus, creatinine, and urinary microalbumin were within normal levels in the both groups. Urinary pH, sodium, potassium, phosphorus, microalbumin, and KIM-1 excretions were similar between the control and study groups. Tubular phosphorus reabsorption was within normal limits in two groups. Urine NAG was elevated in the study group (P = 0.001). Urinary KIM-1 and NAG levels were positively correlated (r = 0.837; P = 0.001). When children with mild and moderate asthma were compared, all of the parameters were similar (P >0.05).
This study showed that chronic asthma can lead to subtle renal impacts. We suggest that in children with asthma, urinary NAG level is a more valuable parameter to show degree of renal tubular injury than markers such as microalbumin and KIM-1. Chronic hypoxy and inflammation probably contributes to these subclinical renal effects.
哮喘是一种气道慢性炎症性疾病，可导致慢性缺氧。慢性缺氧和炎症会影响肾小管功能。
本研究旨在调查哮喘患儿的肾小管功能以及早期肾损伤分子，如尿N-乙酰-β-葡萄糖苷酶（NAG）和肾损伤分子-1（KIM-1）的排泄情况。
本研究纳入了73例诊断为哮喘的儿童和65例年龄及性别匹配的健康对照者。评估了尿pH值、钠、磷、钾、微量白蛋白、肌酐、NAG、KIM-1以及血清肌酐、钠、磷。根据全球哮喘防治创议指南进行哮喘的诊断及轻度或中度的分类。
两组的血清钠、磷、肌酐和尿微量白蛋白均在正常水平。对照组和研究组的尿pH值、钠、钾、磷、微量白蛋白和KIM-1排泄情况相似。两组的肾小管磷重吸收均在正常范围内。研究组的尿NAG升高（P = 0.001）。尿KIM-1和NAG水平呈正相关（r = 0.837；P = 0.001）。比较轻度和中度哮喘患儿时，所有参数均相似（P >0.05）。
本研究表明慢性哮喘可导致轻微的肾脏影响。我们建议，对于哮喘患儿，尿NAG水平比微量白蛋白和KIM-1等标志物更能体现肾小管损伤程度。慢性缺氧和炎症可能导致了这些亚临床肾脏效应。
