The clinical significance of determining markers of endothelial dysfunction in blood serum and urine of children with chronic kidney disease

BACKGROUND. The results of the analysis of the content of markers of endothelial dysfunction in the blood serum and urine of children with chronic nephropathies are presented. The prospects of their use in the complex diagnosis of chronic kidney diseases and assessment of the progression of this pathology are discussed.

THE AIM. To analyze the possibility of using the determination of interleukin-6 and intercellular adhesion molecule-1 (ICAM-1) in serum and urine of pediatric patients in the complex diagnosis of chronic kidney diseases.

PATIENTS AND METHODS. 132 patients with chronic kidney diseases were examined. The comparison group included conditionally healthy children without signs of kidney damage and autoimmune process. Quantitative determination of the level of markers of endothelial dysfunction was performed by enzyme immunoassay.

RESULTS. The concentration of interleukin-6 in the blood serum of patients showed significant differences among all the studied groups (N=162, p<0.001). Urine levels of interleukin-6 also differed significantly in patients of all groups (N=156, p<0.001). According to the Mann-Whitney criterion, significant differences in the content of interleukin-6 in blood serum and urine were noted only in patients of the comparison group with patients of the studied groups. The concentration of ICAM-1 in blood serum did not show significant differences among patients of all groups (N=145, p=0.43). But the differences in the level of ICAM-1 in urine reached statistical significance (N=148, p<0.001). According to the Mann-Whitney criterion, significant differences in ICAM-1 concentrations were noted only in urine among patients of the study groups and the comparison group, among patients with primary and secondary immuno-mediated glomerulopathies. There were no statistically significant correlations between the concentration of markers of endothelial dysfunction in blood serum and urine with the characteristics of renal functions and the activity of the pathological process.

CONCLUSIONS. The determination of markers of endothelial dysfunction can be used in the diagnosis of chronic kidney diseases in children. Further investigation of the concentrations of interleukin-6 and ICAM-1 in blood serum and urine is promising for the differential diagnosis of glomerulopathies among themselves. However, it is not possible to talk about the use of these molecules as a marker of the progression of the pathological process in the renal tissue at this stage of the study.

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