PREDICTION OF UNFAVORABLE COURSE OF GLOMERULONEPHRITIS WITH NEPHROTIC SYNDROME IN CHILDREN: ENZYMURIC CRITERIA

Abstract

The aim of study was to investigate the possibility of using the detection of urine renospecific enzymes activity in children with nephrotic syndrome (NS) as biomarkers of unfavorable disease course prognosis. Materials and methods. The operating characteristics of urine activity values of N-аcethyl- β-D-glucosaminidase (NAG) and β-galactosidase (β-Gal) were estimated in 209 nephrotic children depending on disease course. Results. The high activity of NAG and β-Gal confirms the active participation of renal tubules in pathological process in NS. Likelihood of NS progression increased while saving NAG activity >50 Units and β-Gal >30 Units in 8-10 weeks of therapy and at 1.5-3 years of follow-up after treatment withdrawal; increasing of enzymes levels in 6-9 months on tapering treatment period (NAG >100 Units, β-Gal >60 Units). Changing the enzymes activity in the disease active stage before treatment does not have the prognostic defense. The enzymuric fragment of multimarker parallel cascade system for prediction unfavorable NS course has been created. Conclusion. Urine renospecific enzymes activity (NAG and β-Gal) should be used as markers of the progression in NS children with the optimal terms studies and range parameters as summarized in the proposed prediction system.

Keywords

• nephrotic syndrome, biomarkers, N-аcethyl- β -D-glucosaminidase, β- galactosidase, prognosis, likelihood ratio