Department of Pediatric Nephrology, Namık Kemal University School of Medicine, 59030, Tekirdağ, Turkey.
Department of Pediatric Rheumatology and Nephrology, Pamukkale University School of Medicine, 20070, Kınıklı Yerleşkesi/Denizli, Turkey.
Int Urol Nephrol. 2019 Apr;51(4):571-577. doi: 10.1007/s11255-019-02102-8. Epub 2019 Feb 22.
Acute pyelonephritis is associated with considerable morbidity and potential for renal scarring. Pentraxin3 (PTX3) is a recently discovered mediator of inflammation. The objective of this study was to investigate the changes in serum and urine PTX3 levels in children who had a history of pyelonephritis and were diagnosed with renal parenchymal scar (RPS) and/or vesicoureteral reflux (VUR).
The study included 88 children (31 males, 57 females) aged between 3 months and 18 years. The children included in the study were divided into four groups: VUR with RPS (Group 1), RPS without VUR (Group 2), VUR without RPS (Group 3), and healthy children without a history of hydronephrosis or UTI history (Group 4). After the initial evaluation, the participants were further divided into two more groups and re-evaluated: Children with RPS (Group 1 + 2), children without RPS (Group 3 + 4), children with VUR (Group 1 + 3), and children without VUR (Group 2 + 4).
We found that urine pentraxin 3 (uPTX3) and uPTX3/Creatinine levels were significantly higher in the groups with renal scar with or without VUR than the ones without RPS [mean uPTX3, 3.5 pg/ml (min-max 0.0022-12.3668) vs. 2.2 pg/ml (min-max 0.0022-18.5868) and uPTX3/creatinine, 10.5 pg/mg (min-max 0.0035-51.1) vs. 5.8 pg/mg (min-max 0.0004-78.7), p < 0.01]. uPTX3 levels were not different among the groups with and without VUR. In addition, serum PTX3 levels were not different among the groups.
We showed that urinary PTX3 increased only in patients with scarred kidneys. These results might be helpful to predict RPS due to past pyelonephritis.
急性肾盂肾炎可导致相当大的发病率和潜在的肾瘢痕形成。五聚素 3（PTX3）是一种新发现的炎症介质。本研究的目的是研究有肾盂肾炎病史且诊断为肾实质瘢痕（RPS）和/或膀胱输尿管反流（VUR）的儿童血清和尿液 PTX3 水平的变化。
本研究纳入了 88 名 3 个月至 18 岁的儿童（男 31 名，女 57 名）。研究纳入的儿童分为四组：伴有 RPS 的 VUR（组 1）、无 VUR 的 RPS（组 2）、无 RPS 的 VUR（组 3）和无肾积水或尿路感染史的健康儿童（组 4）。初步评估后，将参与者进一步分为两组并重新评估：有 RPS 的儿童（组 1+2）、无 RPS 的儿童（组 3+4）、有 VUR 的儿童（组 1+3）和无 VUR 的儿童（组 2+4）。
我们发现，有或无 VUR 的肾瘢痕组的尿五聚素 3（uPTX3）和 uPTX3/肌酐水平明显高于无 RPS 组[平均 uPTX3，3.5pg/ml（最小最大值 0.0022-12.3668）与 2.2pg/ml（最小最大值 0.0022-18.5868）和 uPTX3/肌酐，10.5pg/mg（最小最大值 0.0035-51.1）与 5.8pg/mg（最小最大值 0.0004-78.7），p<0.01]。有和无 VUR 的组之间 uPTX3 水平无差异。此外，各组之间血清 PTX3 水平无差异。
我们表明，仅在有瘢痕肾脏的患者中尿 PTX3 增加。这些结果可能有助于预测由于过去肾盂肾炎导致的 RPS。
