Predicting the course of primary obstructive megaureter in children using oxidative stress markers

Abstract

Currently, minimally invasive methods of diagnosis and treatment are being actively developed and implemented in pediatric urology, based on immunological and biochemical studies of the state of both the tubular apparatus of the kidney parenchyma and the organs of the entire urinary system.

Purpose - to study clinical and laboratory diagnostic methods that will allow predicting the effectiveness of treatment based on indicators of the functional state of organs of the urinary system.

Materials and methods. The blood serum of 130 children aged 1 to 48 months was tested: 15 children treated endoscopically; 28 children treated by open surgical method; 87 children without urinary tract obstruction.

Results. In the comparative analysis of markers of oxidative destruction of proteins (aldehydephenylhydrazone - APH, ketonphenylhydrazone - KPH) and nitric oxide metabolites (nitric monoxide - NO, NO synthase - NOS) before and 3-6 months after the restoration of urodynamics, a decrease in the manifestations of oxidative stress was revealed, in particular, NO - in 58.13%, NOS - in 51.16%, APH - in 69.76%, KPH - in 69.76%. Despite the improvement of urodynamics, the absence of positive dynamics of markers of oxidative destruction of proteins (APH and KPH) in 30.23%, nitric oxide metabolites (NO - in 34.88%, NOS - in 41.86%) indicates that the functional capacity of the kidneys in a certain number of patients does not improve.

Conclusions. The study of the content of markers of oxidative stress and the state of the antioxidant system, namely the concentration of NO, NOS, APH and КPH in the blood serum of children after correction of urodynamics are informative markers of the functional state of the kidney. The given data indicate the need for early diagnosis of primary obstructive megaureter in children and the use of staged treatment depending on the degree of urodynamic decompensation. When determining the evaluation of the effectiveness of the treatment, it is the indicators of the functional state of the organs of the urinary system that should be taken into account as the main markers of a positive or negative result of the child’s treatment.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.