HIPEROXALURIYA IN PATIENTS WITH PYELONEPHRITIS: POTENTIAL ROLE IN THE PROGRESSION OF CHRONIC KIDNEY DISEASE
Abstract
Aims: The purpose of the present study was to compare the clinical and laboratory characteristics of patients with pyelonephritis with and without hyperoxaluria (depending on the availability of hyperoxaluria) and to establish the effect of hyperoxaluria to progression of chronic kidney disease (CKD).
Materials and methods: We investigated 94 women with chronic pyelonephritis (mean age 36.9±15.6 years). Patients were divided into II groups depending on the presence of hiperoxaluria. In the I-st group (n=50) there were women with hiperoxaluria (П450 mmol per day), in to the II group (n=44) we included patients without hiperoxaluria.
Results: It was determined that the urine oxalate concentration and its daily excretion had inverse correlation with GFR (r=-0.45; p=0.01 and r=-0.48; p<0.001, respectively). Levels of proteinuria (r=0.47; p<0.001), urine fibronectin (r=0.38; p<0.001) and nitrite (r=0.22; p=0,03), and increased blood pressure (r=0.23; p=0.02) also had true direct correlation with hiperoxaluria. Average of GFR was significantly lower in patients with hiperoxaluria: 68.9±12.1 vs 81.2±13.6 (p<0.001). Moreover, we identified the significant increase of levels of proinflammatory cytokines (TNF-α and IL-1β) and β2-microglobulin in patients of group I.
Conclusions: We believe that hiperoxaluria is a potential risk factor for progression of CKD in patients with pyelonephritis.
Downloads
References
Реброва О. Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA / О. Ю. Реброва. – М. : Медиасфера, 2003. – 312 с.
Степанова Н.М. Роль ФНП-α та IL-1β у прогресуванні хронічного пієлонефриту. / Н. Степанова // Імунологія та алергологія. – 2005. – №3. – С. – 9-12.
Andrew D. Rule. Chronic Kidney Disease in Kidney Stone Formers. / Andrew D. Rule, Amy E. Krambeck, John C. Lieske // CJASN. – 2011. – vol. 6. – № 8.– Р. – 2069-2075.
Davalos М. Oxidative renal cell injury induced by calcium oxalate crystal and renoprotection with antioxidants : a possible role of oxidative stress in nephrolithiasis / M. Davalos, S. Konno, M. Eshghi, M. Choudhury // J. Endourol. – 2010. – Mar, Vol. 24 (3). – Р. 339-345.
Guidelines on Urolithiasis / C. Türk (chairman), T. Knoll (vice-chairman), A. Petrik [et al.] // European Association of Urology. – 2011.
Huang H. S. Changes in renal hemodynamics and urodynamics in rats with chronic hyperoxaluria and after acute oxalate infusion: Role of free radicals. / Huang H. S., Chen J, et al. // Neurourol Urodyn. – 2003. – № 22. – P. – 176- 182.
Hung S. F. Chronic kidney disease affects the stone-free rate after extracorporeal shock wave lithotripsy for proximal ureteric stones. / Hung S. F., Chung S. D., Wang S. M., Yu H. J., Huang H. S. // BJU Int. – 2010. – 105(8). – Р. – 1162-7.
Jiang J. Impact of dietary calcium and oxalate, and Oxalobacter formigenes colonization on urinary oxalate excretion / J. Jiang, J. Knight, L. H. Easter, R. Neiberg [et al.] // J Urol. - 2011. – Vol. 186(1). – Р. 135-139.
John Knight. Intestinal and renal handling of oxalate loads in normal individuals and stone formers. / John Knight, Ross P. Holmes, and Dean G. Assimos // Urol Res. – 2007. – № 35(3). – P. – 111-117.
Khan S. R. Crystal-induced inflammation of the kidneys: Results from human studies, animal models, and tissue-culture studies. / Clin Exp Nephrol. – 2004. – № 8. – P. – 75-88.
Kirjavainen P. V. Abnormal immunological profile and vaginal microbiota in women prone to urinary tract infections / P. V. Kirjavainen, S. Pautler, M. L. Baroja [et al.] // Clin Vaccine Immunol. – 2009. – Vol. 16(1). – Р. 29-36.
Maeda S. Chronic kidney disease in urolithiasis patients following successful extracorporeal shockwave lithotripsy. / Maeda S., Naganuma T., Takemoto Y., Shoji T., Okamura M., Nakatani T. / Mol Med Report. – 2012. – 5(1). – Р. – 3-6.
Mike L Green. Lipid peroxidation is not the underlying cause of renal injury in hyperoxaluric rats. / Mike L Green, Robert W Freel and Marguerite Hatch // Kidney International. – 2005. – № 68. – P. – 2629-2638.
Rashed T. Molecular mechanism of oxalate-induced free radical production and glutathione redox imbalance in renal epithelial cells: Effect of antioxidants. / Rashed T., Menon M., Thamilselvan S. // Am J Nephrol. – 2004. – № 24. – P. – 557-568.
Rice J. A. Mathematical Statistics and Data Analysis / J. A. Rice - 2nd edn. - Duxbury Press, 2006. – Р. 348-353.
Stef Robijn. Hyperoxaluria: a gut–kidney axis? / Stef Robijn, Bernd Hoppe, Benjamin A Vervaet, Patrick C D'Haese1 et al // Kidney International. – 2011. – № 80. – P. – 1146–1158.
Susan R. Marengo. Romani i Oxalate in Renal Stone Disease: The Terminal Metabolite: Excretion of Oxalate. / Susan R. Marengo, Andrea M. P. // Nat Clin Pract Nephrol. – 2008. – №4(7). – P. – 368-377.
Thamilselvan S. Oxalate and calcium oxalate mediated free radical toxicity in renal epithelial cells: Effect of antioxidants. / Thamilselvan S., Khan S. R., Menon M. // Urol Res. – 2003. – № 31. P. – 3-9.
