title: Urinary endothelin-1 excretion according to morpho-functional damage lateralization in reflux nephropathy.
abstract: 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.
authors.affiliation: Department of Clinical Pathophysiology, University of Florence, Florence, Italy.
authors.forename: Catia
authors.initials: C
authors.lastname: Olianti
authors.forename: Alessio
authors.initials: A
authors.lastname: Imperiale
authors.forename: Marco
authors.initials: M
authors.lastname: Materassi
authors.forename: Daniela
authors.initials: D
authors.lastname: Seracini
authors.forename: Rita
authors.initials: R
authors.lastname: Ienuso
authors.forename: Mariasilvia
authors.initials: M
authors.lastname: Tommasi
authors.forename: Alberto
authors.initials: A
authors.lastname: Pupi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Cava
mesh_terms: 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*
chemical_list: D019332:Endothelin-1