Urinary endothelin-1 excretion according to morpho-functional damage lateralization in reflux nephropathy.
BACKGROUND
Reflux nephropathy (RN) is a pathophysiological human model of reduced nephron reserve, due to loss of renal mass, but little information exists about the role of urinary endothelin-1 (uET-1) in this disease. The aim of this study was to assess the presence of uET-1-like-immunoreactivity (uET-1L) in RN patients, particularly if lateralized renal damage existed.


METHODS
Thirty patients with vescico-ureteral reflux (VUR) and consequent RN, were studied. The presence of VUR was established by voiding cysto-urethrography. RN was assessed and graded by 99mTc-dimercapto-succinic acid scan (DMSA). Renal plasma flow (ERPF) was evaluated by (123)I-Hippuran renal sequential scintigraphy, and glomerular filtration rate (GFR) by creatinine clearance. Forty-five healthy subjects were selected as a control group. uET-1L excretion, in both affected and control groups, was assayed.


RESULTS
Mann-Whitney U test showed a significant difference between control and patient groups in both GFR and uET-1L. A good correlation between DMSA grading, single kidney clearance and VUR grade was shown. A significant relationship was also shown between uET-1L and both ERPF and GFR. Patients with RN were divided into two subgroups according to functional damage lateralization. Between the two groups, a significant difference was found only for uET-1L when GFR was applied as a covariate in ANCOVA analysis.


CONCLUSIONS
Our preliminary results confirmed the increase of urinary ET-1L excretion in RN, especially when renal functional injury was lateralized.
Olianti
Catia
C
Department of Clinical Pathophysiology, University of Florence, Florence, Italy.
Imperiale
Alessio
A
Materassi
Marco
M
Seracini
Daniela
D
Ienuso
Rita
R
Tommasi
Mariasilvia
M
Pupi
Alberto
A
La Cava
Giuseppe
G
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019332:Endothelin-1 / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000652:urine*; D008297:Male; D014718:Vesico-Ureteral Reflux / Q000473:pathology / Q000503:physiopathology / Q000652:urine*
D019332:Endothelin-1