Features of Clinical and Immunological Parameters in Chronic Tubulointerstitial Nephritis in Children
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Abstract
In childhood, a chronic (latent or undulating) course of tubulointerstitial nephritis (TIN) is more often observed, due to a genetic predisposition, the development of which is determined by endogenous (congenital and hereditary) factors. This type of non-destructive inflammation, predominantly of the medulla, ends with interstitial fibrosis with the involvement of all structures of the nephron in the pathological process.
Purpose of the study. Determine the value of cytokines in the blood and urine against the background of tubular dysfunctions in CTIN in children.
Research material. We observed 132 patients with chronic TIN (CTIN). Of these, 72 children (54.5%) with relapsing and 60 (45.5%) patients with a latent course of the disease. The average age was 8.85 years (85% of girls from 7.22 to 10.47 years).
Results. The study of the serum concentrations of the studied cytokines in CTIN patients revealed a statistically significant excess of the control values of pro-inflammatory TNF-α. almost six times. Anti-inflammatory IL-4 was almost three times higher than the control values, while the concentration of INF-ᵞ was only doubled. In this case, the patients were characterized by the absence of systemic signs of the activity of the chronic process.
Conclusions. Disturbances of renal function in all manifestations of tubulointerstitial renal lesions in children, regardless of their polyetiology and clinical polymorphism, occur mainly due to its tubular component (reabsorption, osmotic concentration, acido-ammoniogenesis). The severity of tubular disorders is determined by the type of tubulointerstitial renal lesions (p <0.001). The most significant decrease in acidogenesis (p <0.05) was found in the a ctive phase of recurrent tubulointerstitial nephritis.