The effect of complex sanatorium treatment on the level of β2-microglobulin serum and urine in children with chronic pyelonephritis

The aim: to study the effect of various integrated spa treatment schemes on the β₂-microglobulin (β₂MG) dynamics of blood serum and urine in children with various clinical forms of chronic pyelonephritis (CP).

Patients and methods. 254 children with CP, aged 6 to 16 years were included in the study. Secondary CP was diagnosed in 205 (80.71 %) children, primary CP was diagnosed in 49 (19.29 %) children. Patients were randomized into 5 groups: 1 group (n = 48) - comparison group. Spa treatment included a sanatorium-resort regimen, diet 5, physiotherapy, climatotherapy, phytotherapy and balneotherapy. Patients of all subsequent groups, in addition to basic therapy, received peloidotherapy. Children of the 2 group (n = 56) received 6 procedures of galvanopeloidotherapy on the projection area of the; children of 3 group (n = 54) - received 10 procedures of amplipulse peloid therapy on the projection area of the kidneys. Children of the 4 group children (n = 46) received 10 procedures of mud applications on the panty zone. Children of the 5 group 5 (n = 50) received 8 procedures of mud applications on the lumbar projection area. Determined p2-MG in serum and urine using standard sets "DRG int., Inc.", USA.

Results. In patients with secondary CP before treatment, an increase in p2-MG in both biological media was diagnosed, in patients with primary CP, only in urine. On the background of a comprehensive spa treatment, the urine β₂-MG concentration in patients with primary CP was statistically significantly reduced in all groups. Normalized - in 2, 3 and 5 groups. Patients of groups 2 and 3 had a significant difference from the result of the comparison group. In patients with secondary CP 3, the _β2-MG group in both biological media reached reference values. In group 4, it was normalized in serum and significantly reduced in urine. In groups 1,2 and 5, there was no significant change in the level of urine β₂-MG in urine, and in serum there was only in group 5.

Conclusion. For normalization of serum β₂-MG and urine in patients with CP it is advisable to conduct peloidotherapy. The area of mud exposure, duration, combination with the preformed physical factor is determined individually, depending on the clinical form of CP.

1. Argyropoulos C, Chen S, Ng Y et al. Rediscovering Beta-2 Microglobulin As a Biomarker across the Spectrum of Kidney Diseases. Frontiers in Medicine 2017; 4: 73. Doi: 10.3389/fmed.2017.00073

2. Joyce E, Glasner P, Ranganathan S, Swiatecka-Urban A. Tubulointerstitial nephritis: diagnosis, treatment, and monitoring. Pediatr Nephrol 2017; 32(4): 577-587. Doi: 10.1007/s00467-016-3394-5

3. Ikezumi X Uemura O, Nagai T et al. Beta-2 microglobulin-based equation for estimating glomerular filtration rates in Japanese children and adolescents. Clin Exp Nephrol 2015; 19(3):450-457. Doi: 10.1007/s10157-014-1015-9

4. Nielsen R, Christensen El, Birn H. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease. Kidney Int 2016; 89(1):58-67. Doi: 10.1016/j.kint.2015.11.007

5. El-Frargy MS, El-Refaey AM, Eid R, Hussien MA. Serum cystatin-C and BETA 2-microglobulin as accurate markers in the early diagnosis of kidney injury in neonates: a single center study. Saudi J Kidney Dis Transpl 2015;26(4):712-717. Doi: 10.4103/1319-2442.160151

6. Tiktinskii OA, Aleksandrov VP Urolithiasis disease. Piter, SPb., 2000; 314-316

7. Ravnskov U. Glomerular, tubular and interstitial nephritis associated with non-steroidal antiinflammatory drugs. Evidence of a common mechanism. Br J Clin Pharmacol 1999; 47(2):203-210. PMID: 10190656

8. Kho-lopov AP, Shashel' VA, Perov YuM, Nastenko VP. Mud Treatment. Periodika Kubani, Krasnodar., 2003; 283

9. Ponomarenko GN, red.. Fizicheskaya i reabilitatsion-naya meditsina: natsional'noe rukovodstvo. GEOTAR-Media, M., 2016; 688

10. Poddubnaya OA. Sinusoidal'nye modulirovannye toki v klinicheskoy fizioterapii. Fizioterapiya, bal'neologiya i reabilitatsiya 2017;16(1):39-47

11. Samosyuk IZ, Yevtushenko SK, Samo-syuk NI. basic principles for selection of treatment zones and their rationale for use of physical factors in medical rehabilitation. International neurological journal 2012; 8(54):112-122