Endothelial dysfunction indicators in children with hemolytic-uremic syndrome

DOI: https://dx.doi.org/10.18565/pharmateca.2023.1-2.221-225

T.P. Makarova, L.A. Davlieva, Yu.S. Melnikova, D.R. Khusnutdinova

1) Kazan State Medical University, Kazan, Russia; 2) Children’s Republican Clinical Hospital, Kazan, Russia
Background. Hemolytic-uremic syndrome (HUS) is one of the important causes of acute kidney injury (AKI) in children. An analysis of the literature data demonstrates the central role of endothelial dysfunction (ED) in numerous pathophysiological processes, including in kidney disease. This article discusses the ED indicators (endothelin-1 – ET-1 and nitric oxide – NO) in the blood serum of children with HUS.
Objective. Determination of the clinical diagnostic and prognostic value of ET-1 and NO in blood serum in children with HUS.
Methods. The 2-stage study was carried out. At the first stage of the study, a retrospective analysis of 89 case histories of children aged from 3 months to 17 years with a typical form of HUS (stec-HUS) was carried out. The second stage included a prospective study with participation of 31 children with stec-HUS.
Results. As a result of the determination of the blood serum ET-1 level in patients with stec-HUS in the prospective group, a significant increase in its level in the acute period of the disease and before discharge compared with the data of the control group was revealed (P<0.001); when examined a year later, high blood serum ET-1 level in convalescent children with HUS persisted, which indicates a persistent impairment of the vasomotor function of the vascular endothelium in children with HUS. The results of determination of blood serum NO level in children with stec-HUS, on the contrary, showed a decrease in NO level in the acute stage of the disease and before discharge compared with the control group (P<0.05). When examining convalescent children with-HUS 1 year after, an increase in the blood serum NO level was revealed.
Conclusion. The formation of chronic kidney disease (CKD) after stec-HUS and its progression was accompanied by a significant increase in the ET-1 level and a decrease in the NO level in all studied groups compared with the control group (P<0.05), which indicates a violation of the vasomotor function of the endothelium.

About the Autors

Corresponding author: Tamara P. Makarova, Dr. Sci. (Med.), Professor at the Department of Hospital Pediatrics, Kazan State Medical University, Kazan, Russia; -mail: makarova-kgmu@mail.ru

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