Endothelial dysfunction in children with pyelonephritis

Authors

  • O. Ye. Abaturov SЕ “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro,
  • L. I. Vakulenko SЕ “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro,
  • O. V. Kunak MЕ “Dnipropetrovsk Regional Children's Clinical Hospital” DRC”, Dnipro, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2019.4.173343

Keywords:

endothelial dysfunction, pyelonephritis, vascular endothelium, vasodilatation, children

Abstract

 

Aim. To study the characteristics of vascular endothelium system functioning as a marker of the balance between endothelium-dependent vasodilation and endothelium-dependent vasoconstriction in children with acute and chronic pyelonephritis.

Materials and methods. 39 children with acute and 37 with chronic pyelonephritis aged 11–17 years, without exacerbation of the inflammatory process were examined. The control group consisted of 30 apparently healthy children. Endothelium-dependent vasodilatation test adapted to children was used.

Results. In children with acute pyelonephritis, the initial index of the brachial artery diameter did not differ significantly from the norm (3.40 ± 0.19 mm, P > 0.05), while it was significantly less in patients with chronic pyelonephritis (2.20 ± 0.12 mm, P < 0.05). In the phase of maximal vasodilation, the brachial artery diameter index was significantly higher (4.10 ± 0.15 mm, P < 0.05) in patients with acute pyelonephritis, and in patients with chronic pyelonephritis – significantly less than the norm (2.60 ± 0.17 mm, P < 0.05). As a result, the brachial artery diameter increase was significantly less in children with chronic pyelonephritis than in healthy children (8.2 ± 0.2 %, P < 0.05), while it was significantly higher (24.10 ± 0.53 %, P < 0.05) in children with acute pyelonephritis. Linear blood flow velocity at rest was significantly lower than normal (111.80 ± 0.17, P < 0.05) in children with acute pyelonephritis and it was significantly increased (148.70 ± 0.14 cm/s, P < 0.05) in children with chronic pyelonephritis. In the phase of reactive hyperemia, the linear flow velocity was decreased in both groups of patients.

Conclusions. Endothelial dysfunction is registered in 17.9 % of acute pyelonephritis and in 64.9 % of chronic pyelonephritis cases in children. Diverging paths are observed: in patients with acute pyelonephritis, activity of vasodilatory agents predominates, and in chronic pyelonephritis - vasoconstrictor agents. Endothelial dysfunction associated with chronic pyelonephritis has the risk of unfavorable course of the disease and requires differential management.

 

References

Bazarny, V. V., & Averchenko, M. V. (2013). Diagnosticheskaya tsennost' opredeleniya koncentracii faktora rosta e'ndoteliya sosudov pri khronicheskom pielonefrite u detej [Diagnostic value of vascular endothelial growth factor determination in chronic pyelonephritis in children]. Kazanskij medicinskij zhurnal, 94(5), 656–658. [in Russian].

Berezhniy, V., & Romankevych, I. (2016). Vyvchennia funktsionalnoho stanu endoteliiu za dopomohoiu kompleksu pokaznykiv proby z reaktyvnoiu hiperemiieiu [The study of the functional state of the endothelium via a complex of markers with reactive hyperemia]. Sovremennaya pediatriya, 2(74), 112–116. doi: 10.15574/SP.2016.74.112 [in Ukrainian].

Zorin, I. V., Vyalkova, A. A., Gun'kova, E. V., & Plotnikova, S. V. (2017). Endotelial'naya disfunkciya – osnova progressirovaniya reflyuks-nefropatii u detej [Endothelial dysfunction as a basis of progression of reflux nephropathy in children]. Lechaschij vrach, 1, 36. [in Russian].

Ignatova, T. B. (2015). Stan endotelialnoi funktsii u zdorovykh ditei molodshoho shkilnoho viku za danymy trypleksnoho ultrazvukovoho doslidzhennia [State of endothelial function within the healthy children of the younger school age according to data of triplex ultrasonic research]. Sovremennaya pediatriya, 8(72), 54–56. doi: 10.15574/SP.2015.72.54 [in Ukrainian].

Inozemceva, N. D., Zakharova, N. B., & Rossolovskij, A. N. (2015). Znachenie molekulyarnykh markerov v izuchenii e'ndotelial'noj disfunkcii u bol'nykh MKB (obzor literatury) [The importance of molecular markers in the study of endothelial dysfunction in ICD patients (literature review)]. Byulleten' medicinskikh internet-konferencij, 5(6), 902–905. [in Russian].

Korenev, N. M., & Bessonova, I. N. (2014). Sostoyanie pochechnogo krovotoka i e'ndotelial'naya funkciya pochek u podrostkov s arterial'noj gipertenziej i giperurikemiej [Status of renal blood flow and renal endothelial function in adolescents with hypertension and hyperuricemia]. Perinatologiya i pediatriya, 2(58), 80–84. [in Russian].

Makarova, T. P., & Melnikova, Yu. S. (2014). Mekhanizmy razvitiya e'ndotelial'noj disfunkcii pri khronicheskoj bolezni pochek u detej [Mechanisms for the development of endothelial dysfunction in chronic kidney disease in children]. Prakticheskaya medicina, 9(85), 19–23. [in Russian].

Mel'nikova, Yu. S., & Makarova, T. P. (2015). E'ndotelial'naya disfunkciya kak central'noe zveno patogeneza khronicheskikh boleznej [Endothelial dysfunction as the key link of chronic diseases pathogenesis]. Kazanskij medicinskij zhurnal, 96(4), 659–665. [in Russian]. doi: 10.17750/KMJ2015-659

Oksenyuk, O. S., Kalmykova, Yu. A., Smirnova, O. B., & Pasechnik, D. G. (2016). Rol' okislitel'nogo stressa v razvitii khronicheskoj bolezni pochek i sposoby ego ocenki [The role of oxidative stress in the development of chronic kidney disease and methods of its evaluation]. Zhurnal fundamental'noj mediciny i biologii, 1, 15–24. [in Russian].

Smirnov, I. E., Kucherenko, A. G., & Komarova, O. V. (2014). Biomarkery formirovaniya nefroskleroza pri khronicheskoj bolezni pochek u detej [Biomarkers of the formation of nephrosclerosis in chronic kidney disease in children]. Rossijskij pediatricheskij zhurnal, 17(6), 10–15. [in Russian].

Shabrov, A., Apresyan, A., Dobkes, A., Ermolov, S., Ermolova, T., Manasyan, S., & Serdyukov, S. (2016). Sovremennye metody ocenki e'ndotelial'noj disfunkcii i vozmozhnosti ikh primeneniya v prakticheskoj medicine [Current Methods of Endothelial Dysfunction Assessment and their Possible Use in the Practical Medicine]. Racional'naya farmakoterapiya v kardiologii, 12(6), 733–742. [in Russian].

Carlstrom, M., & Montenegro, M. F. (2019) Therapeutic value of stimulating the nitrate-nitrite-nitric oxide pathway to attenuate oxidative stress and restore nitric oxide bioavailability in cardiorenal disease. J. Intern. Med., 285(1), 2–18. doi: 10.1111/joim.12818

Chen, J., Hamm, L. L., Mohler, E. R., Hudaihed, A., Arora, R., Chen, C. S., et al. (2015). Interrelationship of Multiple Endothelial Dysfunction Biomarkers with Chronic Kidney Disease. PLoS ONE, 10(7), e0132047. doi: 10.1371/journal.pone.0132047

Drożdż, D., Łątka, M., Drożdż, T., Sztefko, K., & Kwinta, P. (2018). Thrombomodulin as a New Marker of Endothelial Dysfunction in Chronic Kidney Disease in Children. Oxid. Med. Cell. Longev, 2018, 1619293. doi: 10.1155/2018/1619293

Goligorsky, M. S. (2015). Pathogenesis of endothelial cell dysfunction in chronic kidney disease: a retrospective and what the future may hold. Kidney Res. Clin. Pract., 34(2), 76–82. doi: 10.1016/j.krcp.2015.05.003

Guan, Z., Van Beusecum, J. P., & Inscho, E. W. (2015). Endothelin and the renal microcirculation. Semin. Nephrol., 35(2), 145–55. doi: 10.1016/j.semnephrol.2015.02.004

Higashi, Y. (2015). Assessment of endothelial function. History, methodological aspects, and clinical perspectives. Int. Heart J., 56(2), 125–134. doi: 10.1536/ihj.14-385

Matsuzawa, Y., Kwon, T. G., Lennon, R. J., Lerman, L. O., & Lerman, A. (2015). Prognostic Value of Flow-Mediated Vasodilation in Brachial Artery and Fingertip Artery for Cardiovascular Events: A Systematic Review and Meta-Analysis. J. Am. Heart Assoc., 4(11), pii: e002270. doi: 10.1161/JAHA.115.002270

Si, D., Ni, L., Wang, Y., Liu, J., Yang, J., & Yang, P. (2018). A new method for the assessment of endothelial function with peripheral arterial volume. BMC Cardiovasc Disord, 18(1), 81. doi: 10.1186/s12872-018-0821-5

Xu, Y., Arora, R.C., Hiebert, B. M., Lerner, B., Szwajcer, A., McDonald, K., et al. (2014). Non-invasive endothelial function testing and the risk of adverse outcomes: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging, 5(7), 736–746. doi: 10.1093/ehjci/jet256

Downloads

How to Cite

1.
Abaturov OY, Vakulenko LI, Kunak OV. Endothelial dysfunction in children with pyelonephritis. Zaporozhye medical journal [Internet]. 2019Jul.15 [cited 2024Apr.26];(4). Available from: http://zmj.zsmu.edu.ua/article/view/173343

Issue

No. 4 (2019)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)