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NDT Advance Access published online on March 19, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh171
© 2004 by European Renal Association - European Dialysis and Transplant Association
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Received September 22, 2003
Accepted January 21, 2004

Preliminary Communication

Urinary endothelin-1 excretion according to morpho-functional damage lateralization in reflux nephropathy

Catia Olianti 1, Alessio Imperiale 1, Marco Materassi 2, Daniela Seracini 2, Rita Ienuso 3, Mariasilvia Tommasi 1, Alberto Pupi 1, Giuseppe La Cava 1*

1 Nuclear Medicine Unit, Department of Clinical Pathophysiology, University of Florence, Florence, Italy
2 Department of Pediatrics, University of Florence, Florence, Italy
3 Department of Radiology, ‘Anna Meyer’ Pediatric Hospital, Florence, Italy

* To whom correspondence should be addressed. E-mail: g.lacava{at}dfc.uni.it.



  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 123I-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.

Conclusion. Our preliminary results confirmed the increase of urinary ET-1L excretion in RN, especially when renal functional injury was lateralized.

Keywords: endothelin-1; ERPF; GFR; 123-I-OIH; reflux nephropathy; vescicoureteral reflux


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