Indicators of renal fibrosis in children receiving conservative treatment for chronic kidney disease
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Katedra i Klinika Nefrologii Pediatrycznej, Wrocławski Uniwersytet Medyczny
Kinga Musiał
Katedra i Klinika Nefrologii Pediatrycznej, Wrocławski Uniwersytet Medyczny, ul. Borowska 213, 50-556 Wrocław
Med Og Nauk Zdr. 2013;19(1):41–44
Background and Objective:
Matrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs), adhesion molecules and heat shock proteins (hsp) may play an essential role in the process of renal fibrosis, but the data concerning such influence in the patients with chronic kidney disease (CKD) on conservative treatment are scarce. The objective of the study was to assess the concentrations of Hsp90a, sE-selectin, MMP-2, TIMP-1 and TIMP-2 in the predialysis CKD children and potential relations between these parameters.

Material and Methods:
65 children were enrolled in the study and divided into those with CKD stage 3-4 (CKD I) and CKD stage 5 (CKD II). 30 age-matched subjects with primary nocturnal enuresis and normal kidney function served as controls. The serum concentrations of Hsp90a, sE-selectin, MMP-2, TIMP-1 and TIMP-2 were assessed by ELISA.

The median values of Hsp90a, sE-selectin, MMP-2, TIMP-1 and TIMP-2 were significantly elevated in CKD patients vs. controls. The concentrations kept growing together with the progressing renal failure in the case of sE-selectin and MMP-2, remained unchanged in the case og TIMP-1 and TIMP-2, whereas diminished in the case of Hsp90a. Several correlations between examined parameters were noticed.

Conclusions. The increased concentrations of Hsp90a, sE-selectin, MMP-2, TIMP-1 and TIMP-2 indicate the enhanced cell damage, aggravation of inflammatory and proteolytic processes, responsible for progression of interstitial renal fibrosis in CKD children. Differences in behaviour of selected parameters in the course of renal failure progression suggest the diversity of their engagement in various stages of CKD

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