Changes in Urinary Nitric Oxide in Pediatric Renal Diseases

Kim, Jong-Hwa; Jung, Ji-In; Yim, Hyung-Eun; Hong, Young-Sook; Lee, Joo-Won; Yoo, Kee-Hwan

doi:2007.11.1.24

J Korean Soc Pediatr Nephrol > Volume 11(1); 2007 > Article

J Korean Soc Pediatr Nephrol 2007;11(1): 24-31. doi: https://doi.org/10.3339/jkspn.2007.11.1.24

소아 신장질환에서 소변 내 산화질소의 변화

김종화, 정지인, 임형은, 홍영숙, 이주원, 유기환

¹고려대학교 의과대학 소아과학교실
²고려대학교 의과대학 소아과학교실
³고려대학교 의과대학 소아과학교실
⁴고려대학교 의과대학 소아과학교실
⁵고려대학교 의과대학 소아과학교실
⁶고려대학교 의과대학 소아과학교실

Changes in Urinary Nitric Oxide in Pediatric Renal Diseases

Jong-Hwa Kim, Ji-In Jung, Hyung-Eun Yim, Young-Sook Hong, Joo-Won Lee, Kee-Hwan Yoo

¹Department of Pediatrics, Korea University College of Medicine
²Department of Pediatrics, Korea University College of Medicine
³Department of Pediatrics, Korea University College of Medicine
⁴Department of Pediatrics, Korea University College of Medicine
⁵Department of Pediatrics, Korea University College of Medicine
⁶Department of Pediatrics, Korea University College of Medicine

ABSTRACT

Purpose : Nitric oxide(NO) is a very potent vasodilator synthesized from L-arginine by endothelial cells. We investigated whether urinary NO excretion was altered in various renal diseases in children and whether urinary NO excretion could be used in predicting pathologic causes and fibrosis in renal diseases in children.
Methods : We recruited 48 patients(32 minimal change nephrotic syndrome[MCNS] and 16 vesicoureteral reflux[VUR] patients from the pediatric renal clinic in Korea University Guro Hospital. We measured the concentration of nitrite$(NO_2)$ and nitrate$(NO_3)$ by Griess reaction and that of creatinine(Cr) by Jaffe method in randomized spot urines. We then analyzed the urinary$(NO_2+NO_3)/Cr$ ratios and compared the values between each patient group. Urinary $(NO_2+NO_3)/Cr$ ratios were also evaluated according to the recurrence and the degree of proteinuria at sampling in the MCNS group and compared according to the presence of renal scarring and the grade of reflux in the VUR group.
Results : The ratios of urinary$(NO_2+NO_3)/Cr$ were significantly increased in the VUR and MCNS groups, as compared to the control group. In the MCNS group, a higher level of urine $(NO_2+NO_3)/Cr$ was observed In frequent relapse patients(relapse over four times within one year after first diagnosis) and the patients with severe proteinuria at sampling, respectively. The VUR group with renal scars also showed a higher level of urinary$(NO_2+NO_3)/Cr$ compared to that without scars.
Conclusions : In summary, VUR may play a role in the pathogenesis of VUR and MCNS. NO also seems to affect proteinuria and renal scar formation.

Key words: Nitric Oxide | Proteinuria | Fibrosis