Influence on the connective tissue dysplasia, hormones and cytokines in children with kidney disease acquired in the form of glomerulonephritis, haemolytic uraemic syndrome and secondary pyelonephritis

Abstract

Previously we found an adverse effect of undifferentiated connective tissue dysplasia (UCTD) on the development of nephrosclerosis in children with congenital malformations of urinary system organs. This article is devoted to the analysis of the influence of the State on the UCTD clinical course of acquired diseases of the kidneys in the form of glomerulonephritis, haemolytic uraemic syndrome and secondary pyelonephritis, as well as the production of hormones of Renin-angiotensin-aldosterone system and proinflammatory cytokines (TNF-α and Il-1β). 99 patients with acquired renal diseases were examined. 25 of them – children with tubulo-interstitial nephritis after haemolytic uraemic syndrome; 38 patients with chronic glomerulonephritis with nephrotic syndrome; 36 children with secondary not obstructive pyelonephritis. A control group consisted of 30 clinically healthy children of the appropriate age. NDST diagnosis has been carried out in accordance with the Russian recommendations on the diagnostics algorithms of violation of the structure and function of connective tissue. UCTD status was diagnosed in 36% of children with tubulointerstitial nephritis, 40% of children with chronic glomerulonephritis and 27.8% of children with pyelonephritis. All children underwent a complete nephro-urological examination using clinical, laboratory and instrumental methods: ultrasound of the urinary system, electrocardiography, echo-cardiography, daily blood pressure monitoring. Concentration of Renin, aldosterone plasma, as well as TNF-α and Il-1β was determined by immunoenzyme method. The results of the work have shown a significant adverse impact on the UCTD partial violation of the kidneys, the frequency of relapses secondary pyelonephritis, arterial hypertension and formation of steroid resistance steroid resistance in glomerulonephritis. In most patients the overproduction of Renin, aldosterone and both cytokines is accompanied with UCTD, which contributes to the progression of chronic renal disease. According to modern views, undifferentiated connective tissue dysplasia is the result of polygenic inherited predispositions to violate morphogenesis components of the extracellular matrix and is considered as the basis the formation of many chronic diseases. UCTD frequency in patients with acquired renal diseases is not investigated. This condition influence on the clinical course of the underlying disease, the production of hormones renin-angiotensin-aldosterone system and proinflammatory cytokines has not been studied.