Nowe markery aterogenezy u dzieci z przewlekłą chorobą nerek leczonych zachowawczo

Abstract

IntroductionMatrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs) and neutrophil gelatinase-associated lipocalin (NGAL) may play an essential role in atherosclerosis progression, but the data concerning such influence in the patients with chronic kidney disease (CKD) on conservative treatment are scarce. AimThe aim of the study was to assess the concentrations of NGAL and selected MMPs in the predialysis CKD children, in relation to the markers of endothelial damage and inflammation. Material and methods37 children were enrolled in the study and divided into those with CKD stage 2–3 (gr. I) and CKD stage 4–5 (gr. II). 24 age-matched subjects with primary nocturnal enuresis and normal kidney function served as controls. The serum concentrations of NGAL, MMP-7, TIMP-2, sE-selectin and IL-4 were assessed by ELISA. ResultsThe median values of NGAL, MMP-7 and TIMP-2 were elevated in CKD patients vs. controls and kept growing together with the progressing renal failure. The values of MMP-7/TIMP-2 ratio were lower in the CKD children than in the control group and their decline was proportional to the decreasing glomerular filtration. All parameters correlated with creatinine clearance, markers of endothelial damage and inflammation. ConclusionsThe increased concentrations of NGAL, MMP-7 and TIMP-2 may indicate the proteolytic overactivity in CKD children, aggravating with the progression of renal failure. The correlations between examined parameters suggest the role for NGAL and metalloproteinases in the process of atherogenesis.