Janaina Matos Moreira1,2, Albená Nunes da Silva3, Érica Leandro Marciano Vieira1, Antônio Lúcio Teixeira1, Arthur Melo Kummer1, Ana Cristina Simões E Silva4,5,6. 1. Interdisciplinary Laboratory of Medical Research (LIIM) of the Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil. 2. Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil. 3. Exercise Immunology and Inflammation Laboratory (LABIIEX/CEDUFOP), Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil. 4. Interdisciplinary Laboratory of Medical Research (LIIM) of the Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil. acssilva@hotmail.com. 5. Pediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, UFMG, Belo Horizonte, Minas Gerais, Brazil. acssilva@hotmail.com. 6. Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Avenida Alfredo Balena, 190, 2° andar, sala 281, Belo Horizonte, Minas Gerais, Zip Code: 30130-100, Brazil. acssilva@hotmail.com.
Abstract
BACKGROUND: In adult chronic kidney disease (CKD) patients, there is a positive association between inflammation and progressive renal dysfunction. Higher levels of soluble receptors of tumor necrosis factor (sTNFR) have been related to worst prognosis of adult CKD patients. Therefore, the present study aimed to evaluate soluble TNF receptors in children and adolescents with CKD and to search for an association with clinical and laboratory features. METHODS: Demographic, clinical, anthropometric, and laboratory data were evaluated in 34 pediatric patients with CKD and in 34 healthy sex- and age-matched controls. Blood samples were collected in both groups to measure sTNFR by enzyme-linked immunosorbent assay. The modified Schwartz formula was used to estimate glomerular filtration rate (GFR). RESULTS: Pediatric patients with CKD had significantly higher plasma concentrations of soluble TNF receptors types 1 and 2 (sTNFR1 and sTNFR2) in comparison to sex- and age-matched healthy controls. Plasma levels of sTNFR1 and sTNFR2 increased progressively as renal function worsened, being inversely and significantly correlated with GFR (r = - 0.853 for sTNFR1 and GFR, r = - 0.729 for sTNFR2 and GFR). CONCLUSIONS: Children and adolescents with CKD exhibited higher plasma levels of sTNFR1 and sTNFR2 than healthy controls, which increased in relation to renal function deterioration. Plasma levels of sTNFR1 and sTNFR2 emerge as markers of progressive CKD in pediatric patients.
BACKGROUND: In adult chronic kidney disease (CKD) patients, there is a positive association between inflammation and progressive renal dysfunction. Higher levels of soluble receptors of tumor necrosis factor (sTNFR) have been related to worst prognosis of adult CKDpatients. Therefore, the present study aimed to evaluate soluble TNF receptors in children and adolescents with CKD and to search for an association with clinical and laboratory features. METHODS: Demographic, clinical, anthropometric, and laboratory data were evaluated in 34 pediatric patients with CKD and in 34 healthy sex- and age-matched controls. Blood samples were collected in both groups to measure sTNFR by enzyme-linked immunosorbent assay. The modified Schwartz formula was used to estimate glomerular filtration rate (GFR). RESULTS: Pediatric patients with CKD had significantly higher plasma concentrations of soluble TNF receptors types 1 and 2 (sTNFR1 and sTNFR2) in comparison to sex- and age-matched healthy controls. Plasma levels of sTNFR1 and sTNFR2 increased progressively as renal function worsened, being inversely and significantly correlated with GFR (r = - 0.853 for sTNFR1 and GFR, r = - 0.729 for sTNFR2 and GFR). CONCLUSIONS:Children and adolescents with CKD exhibited higher plasma levels of sTNFR1 and sTNFR2 than healthy controls, which increased in relation to renal function deterioration. Plasma levels of sTNFR1 and sTNFR2 emerge as markers of progressive CKD in pediatric patients.
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