1.The renal pathological change of 31 Henoch-Sch(o)nlein purpura with normal urine routine
Yanlan ZHONG ; Xiqiang DANG ; Xiaojie HE ; Zhuwen YI ; Qingnan HE
Journal of Chinese Physician 2012;14(3):322-324
Objective To research Henoch-Schonlein purpura purpura (HSP) and renal pathology in children.Methods 31 hospitalized HSP children that with normal urine routine and accepted renal biopsy in our hospital.Results There were different levels of kidney pathological damage in this group of 31 cases,the results of light microscope were from grade Ⅱ to grade Ⅵ The proportion was grade Ⅱ(35.48%,11 of 31),grade Ⅲ (54.83%,17 of 31),and grade Ⅳ,Ⅴ and Ⅵ (each 1 case of 31,3.23% ).lmmunofluorescence pathology results were showed as following:merely IgA depositional (48.38%,15 of 31 ),IgA + IgG depositional ( 19.36%,6 of 31 ),IgA + IgM depositional ( 19.36%,6of 31 ),IgA + igG + IgM depositional ( 12.90%,4 of 31 ).Microalbuminuria had been founded in 14 cases,and the microalbuminuria level of 10 cases were higher than normal value( 10 of 14,71.43% ).Conclusions HSP children had renal pathologic dysfunction,even the urine routine were normal,and the detection of urine microalbumin was a significant marker in the early stage.
2.Clinical research of urine neutrophil gelatinase-associated lipocalin and interleukin-18 on critically ill patients with acute kidney injury receiving continuous veno-venous hemofiltration
Huiying DENG ; Fazhan ZHONG ; Yan GAO ; Ming LI ; Yanlan WU ; Huabin YANG ; Yingjie LI
Chinese Journal of Applied Clinical Pediatrics 2015;30(5):355-358
Objective To explore the effect of urine neutrophil gelatinase-associated lipocalin(uNGAL) and urine interleukin-18(uIL-18) on the ill condition and prognosis in critically ill patients with acute kidney injury (AKI) at inception of continuous veno-venous hemofiltration (CVVH).Methods Children came from Department of Nephrology,PICU and health examination center in Guangzhou Women and Children's Medical Center were divided into 4 groups:critically ill patients with AKI receiving CVVH group(group A),critically ill patients with non-AKI receiving CVVH group(group B),critically ill patients with AKI didn't recevie CVVH group(group C),and healthy control group(group D).Serum creatinine(SCr),uNGAL and uIL-18 in all patients were analyzed.Results The uNGAL in group A and group C [(161.56 ± 71.44) μg/L,(153.69 ±51.33) μg/L] increased obviously when compared with group B and group D [(33.50 ± l 0.76) μg/L,(16.37 ± 6.20) μg/L] (all P < 0.05).The uIL-18 in group A and group C[(4.16 ±1.13) μg/L,(3.81 ± 1.05) μg/L] was higher than that in group B and group D [(0.25 ± 0.04) μg/L,(0.19 ± 0.15) μg/L] (all P < 0.05).There was no significance of uNGAL and uIL-18 between group B and group D(all P > 0.05).The peak level of uNGAL[(241.76 ± 53.60) μg/L vs (196.32 ± 39.28) μg/L] and uIL-18[(5.15 ±0.78) μg/L vs (4.30 ±0.89) μg/L] in critically ill patients with AKI was higher in renal recoveries than in renal non-recoveries(P <0.05).The levels of uNGAL and uIL-18 critically ill patients at initiation of CVVH were higher in non-survivors when compared with survivors [(213.50 ± 104.78) μg/L vs (79.91 ± 55.81) μg/L,P < 0.05],[(4.48 ± 2.32) μg/L vs (1.94 ± 1.88) μg/L,P < 0.05].The levels of uNGAL and uIL-18 of critically ill patients with AKI at initiation of CVVH were higher in non-survivors than in survivors [(256.99 ± 49.33) μg/Lvs (127.11 ±38.99) μg/L,P<0.05],[(5.48±0.67) μg/Lvs (3.65 ±0.98) μg/L,P<0.05].The levels of uNGAL and uIL-18 at the first diagnosis time of AKI were higher in non-survivors than in survivors (P < 0.05).Conclusions uNGAL and urine IL-18 at commencement of CVVH predicts short-term prognosis in critically ill patients with AKI.uNGAL and urine IL-18 can be as a prognostic value in the prediction of the need for renal replacement therapy initiation or mortality in critically ill patients with AKI.