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评估先天性脊柱侧凸和肾及尿路先天性异常儿童的肾功能。

Evaluation of Renal Function in Children with Congenital Scoliosis and Congenital Anomalies of the Kidney and Urinary Tract.

机构信息

Department of Othopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland).

Department of Nephrology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland).

出版信息

Med Sci Monit. 2018 Jul 6;24:4667-4678. doi: 10.12659/MSM.908839.

Abstract

BACKGROUND The aim of this study was to compare renal function in children with congenital scoliosis and congenital anomalies of the kidney and urinary tract, with healthy children. MATERIAL AND METHODS Biochemical tests were performed before surgery (pre-therapy) and after surgery (post-therapy) in 16 children with congenital scoliosis and congenital anomalies of the kidney and urinary tract. Thirty-two healthy children were matched for age, sex, and weight (healthy controls). General renal function tests included serum electrolytes, creatinine, urea, cystatin C, and estimated glomerular filtration rate (eGFR). Tests for early renal changes included N-acetyl-beta-D-glucosaminidase (NAG), urine microalbumin, serum transferrin, immunoglobulin G (IgG), urinary alpha-1-microglobulin (A1M), and beta-2-microglobulin (B2M). RESULTS Sixteen patients with congenital anomalies of the kidney and urinary tract included eight boys (mean age, 11.38±2.00 years) and eight girls (mean age, 11.00±2.78 years). There were no significant differences in renal function between the pre-therapy and post-therapy groups (P>0.05), or between the three groups (pre-therapy, post-therapy, and healthy controls). In the pre-therapy group, there were significant differences in IgG, A1M, NAG, and serum phosphate levels between boys and girls, urine microalbumin was significantly increased in girls, but not boys (P<0.05). There were no significant differences between the pre-therapy group and post-therapy group (P>0.05). CONCLUSIONS Routine tests of renal function were normal in children with congenital scoliosis and congenital anomalies of the kidney and urinary tract, but early changes in renal function occurred before surgical treatment, indicating long-term follow-up of renal function is recommended.

摘要

背景

本研究旨在比较先天性脊柱侧凸和先天性肾及尿路畸形患儿与健康儿童的肾功能。

材料与方法

对 16 例先天性脊柱侧凸和先天性肾及尿路畸形患儿进行手术前(治疗前)和手术后(治疗后)的生化检查。并选择 32 例健康儿童作为年龄、性别和体重匹配的健康对照组。一般肾功能检查包括血清电解质、肌酐、尿素、胱抑素 C 和估算肾小球滤过率(eGFR)。早期肾损伤检查包括 N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿微量白蛋白、血清转铁蛋白、免疫球蛋白 G(IgG)、尿α-1-微球蛋白(A1M)和β-2-微球蛋白(B2M)。

结果

16 例先天性肾及尿路畸形患儿中,男 8 例(平均年龄 11.38±2.00 岁),女 8 例(平均年龄 11.00±2.78 岁)。治疗前和治疗后两组间肾功能无显著差异(P>0.05),三组间也无显著差异(治疗前、治疗后和健康对照组)。在治疗前组中,男女间 IgG、A1M、NAG 和血清磷水平存在显著差异,女孩尿微量白蛋白显著升高,但男孩无此改变(P<0.05)。治疗前组和治疗后组间无显著差异(P>0.05)。

结论

先天性脊柱侧凸和先天性肾及尿路畸形患儿常规肾功能检查正常,但在手术治疗前已出现早期肾功能改变,提示需长期随访肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a365/6069507/4a9fde4e4772/medscimonit-24-4667-g001.jpg

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