Abstract
ABSTRACTIntroduction:The Renin-Angiotensin-Aldosterone System (RAAS) has been suggested as a possible marker of renal injury in chronic diseases. This study proposes to analyze the serum and urinary markers of the RAAS in myelomeningocele patients with renal function abnormalities detected on DMSA.Material and Methods:Seventeen patients followed in our institution that presented with renal injury on DMSA. We review nephrologic and urologic clinical aspects and evaluated ultrassonagraphy, voiding urethrocystography and urodynamics. Urinary and serum samples were collected to evaluate possible correlations of renal lesions with RAAS. Control group urine and serum samples were also sent for analysis.Results:Serum ACE 2 activity means in relation to urodynamic findings were the only values that had a statistically significant difference (p = 0.040). Patients with normal bladder pattern presented higher ACE 2 levels than the high risk group. Statistical analysis showed that the study group (SG) had a significantly higher mean serum ACE than the CG. The means of ACE 2 and urinary ACE of the SG and CG were not statistically different. The ROC curve for serum ACE values had a statistically significant area for case and non-case differentiation, with 100% sensitivity and 53% specificity for values above 60.2 mg/dL. No statistically significant areas were observed in relation to ACE 2 and urinary ACE values between SG and CG.Conclusion:The analysis of serum ACE, ACE 2 and urinary ACE were not significant in patients with myelomeningocele and neurogenic bladder with renal injury previously detected by renal DMSA.
Highlights
The Renin-Angiotensin-Aldosterone System (RAAS) has been suggested as a possible marker of renal injury in chronic diseases
The Renin-Angiotensin-Aldosterone System (RAAS) plays an important role in regulating blood pressure and electrolyte homeostasis through the release of renin by juxtaglomerular cells, and it has been suggested as a possible marker of renal injury in chronic diseases
This study proposes to analyze the serum and urinary markers of the Renin-Angiotensin-Aldosterone System in myelomeningocele patients with renal function abnormalities detected on DMSA scintigraphy in order to identify whether they can be used as diagnostic and prognostic markers of the kidney damage secondary to bladder abnormalities that may occur in this condition
Summary
The Renin-Angiotensin-Aldosterone System (RAAS) has been suggested as a possible marker of renal injury in chronic diseases. This study proposes to analyze the serum and urinary markers of the RAAS in myelomeningocele patients with renal function abnormalities detected on DMSA. Conclusion: The analysis of serum ACE, ACE 2 and urinary ACE were not significant in patients with myelomeningocele and neurogenic bladder with renal injury previously detected by renal DMSA. The Renin-Angiotensin-Aldosterone System (RAAS) plays an important role in regulating blood pressure and electrolyte homeostasis through the release of renin by juxtaglomerular cells, and it has been suggested as a possible marker of renal injury in chronic diseases. This study proposes to analyze the serum and urinary markers of the Renin-Angiotensin-Aldosterone System in myelomeningocele patients with renal function abnormalities detected on DMSA scintigraphy in order to identify whether they can be used as diagnostic and prognostic markers of the kidney damage secondary to bladder abnormalities that may occur in this condition Gobet et al [3] observed that in fetal-onset renal diseases, as well as in postnatal renal diseases, RAAS played an important role in renal interstitial fibrosis, possibly by activating the transforming growth factor-beta (TGF-β1), which has the function of controlling cell proliferation and differentiation, and other functions in most cells.
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