Urinary high-sensitivity C-reactive protein in patients with neurogenic bladder after meningomyelocele (MMC)
DOI:
https://doi.org/10.12775/MBS.2015.024Keywords
neurogenic bladder, renal function, high sensitivity C-reactive protein, glomerular hyperfiltrationAbstract
Introduction. Neurogenic bladder (NB) is specific condition caused by disturbed bladder innervation and the most often complication of meningomyelocele (MMC). It is known that incorrect bladder function causes renal damage. Condition of NB is worsened by urinary tract infections, detrusor overactivity, dysfunctional voiding and/or irregular catheterization. hs-CRP plays an important role in inflammatory process and can predict kidney function.
The aim of this study was the estimation of urinary hs-CRP level in association with neurogenic bladder function based on urodynamics and renal function based on eGFR in MMC patients with various activity states and with different levels of lesion.
Material and methods. 33 children and adolescents with urodynamically confirmed neurogenic bladder and 20 healthy individuals were enrolled into the study. Patients were divided according to Hoffer’s scale and level of lesion. Urinary hs-CRP were evaluated in all individuals using ELISA methods. Urinary hs-CRP results were adjusted to the creatinine and expressed as hs-CRP/creatinine ratio. Nonparametric tests were used for statistical analysis.
Results. When compared to the reference group, MMC patients showed increased urinary hs-CRP. There were no differences in the studied parameter between boys and girls, non- and catheterized, and with different urodynamic diagnosed children. We found positive correlations between Hoffer’s scale assessing physical activity and level of lesion and between GFR and urinary hs-CRP/crea.
Conclusion. Urinary hs-CRP level is elevated in MMC patients compared to reference group and could be considered as a very early marker of glomerular hyperfiltration.References
de Groat WC. Integrative control of the lower urinary tract: preclinical perspective. B. J. Pharm. 2006;147:25-40.
Korzeniecka-Kozerska A, Porowski T, Michaluk-Skutnik et al. Urinary nerve growth factor level in children with neurogenic bladder due to meningomeyleocele. Scand. J. Urol. 2013;47(5):411-17.
Korzeniecka-Kozerska A, Okurowska-Zawada B, Michaluk-Skutnik J et al. The assessment of thiol status in children with neurogenic bladder caused by meningomyelocele. Urol. J. 2014;2:1400-5.
Olandoski KP, Koch V, Trigo-Rocha FE. Renal function in children with congenital neurogenic bladder. Clinics 2011;66(2):189-95.
Thorup J, Biering-Sorensen, Cortez D. Urological outcome after myelomeningocele: 20 years of follow-up. B.J.U. Int. 2010;107:994-9.
Sesso HD, Buring JE, Rifai N et al. C-reactive protein and the risk of developing hypertension. J.A.M.A. 2003;290:2945-51.
Levitsky J, Freifeld A, Lyden E et al. Evaluation of the coagulation and inflammatory responses in solid organ transplant recipients and donors. Clin. Transplant. 2009 Nov-Dec;23(6):943-50.
Kapelian V, Rosen RC, Roehrborn CG et al. Association of overactive bladder and C-reactive protein levels: results from the Boston area Community Health (BACH) Survey. B.J.U. Int. 2012;110(3):401-7.
Chung SD, Liu HT, Lin H et al. Elevation of serum C-reactive protein in patients with OAB and IC/BPS implies chronic inflammation in the urinary bladder. Neurourol. Urodyn. 2011;30:417-20.
Hsiao SM, Lin HH, Kuo HC. The role of serum C-reactive protein in women with lower urinary tract symptoms. Int. Urogynecol. 2012;J 23(7):935-40.
Ferreira CE, Fonseca AM, Silva ID et al. The relationship between the Trp 64 Arg polymorphism of the beta 3-adrenoceptor gene and idiopathic overactive bladder. Am. J. Obstet. Gynecol. 2011;205(1):82.e10–14.
Shim SS, Romero R, Jun JK et al. C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes. J. Matern. Fetal. Neonatal. Med. 2005;18:417-22.
Defauw P, Schoeman JP, Smets P et al. Assessment of renal dysfunction using urinary markers in canine babesiosis caused by Babesia rossi. Vet. parasitol. 2012;190:326-32.
Martinez-Subiela S, Garcia-Martinez JD, Tvarijonaviciute A et al. Urinary C reactive protein levels in dogs with leishmaniasis at different stages of renal damage. Res. Vet. Sci. 2013;95(3):924-9.
Ortiz RM, Mamalis A, Navar LG. Aldosterone receptor antagonism reduces urinary C-reactive protein excretion in angiotensin II-infused, hypertensive rats. J. Am. Soc. Hypertens. 2009;3:184-91.
Levey AS. Measurement of renal function in chronic renal disease. Kidney. Int.1990;38:167-84.
Counahan R, Chantler C, Ghazali S et al. Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch. Intern. Med. 1976;51:875–78.
Vora JP, Dolben J, Dean JD et al. Renal hemodynamics in newly presenting non-insulin dependent diabetes mellitus. Kidney. Int. 1992;41:829-35.
Heikkila K, Ebrahim S, Lawlor DA. A systematic review of the association between circulating concentration of C reactive protein and cancer. J. Epidemiol. Community Health 2007;61:824-33.
Cho KJ, KIM JC. Biomarkers for lower urinary tract dysfunction. Int. J. Urol. 2013;20:13-20.
Masuda H, Kihara K, Saito K et al. Reactive oxygen species mediate detrusor overactivity via sensitization of afferent pathway in the bladder of anesthetized rats. B.J.U. Int. 2008;101:775-80.
de Jongh R, Haenen GR, van Koeveringe GA et al. Oxidative stress reduces the muscarinic receptor function in the urinary bladder. Neurourol. Urodyn. 2007;26:302-8.
Azadzoi KM, Yalla SV, Siroky MB. Oxidative stress and neurodegeneration in the ischemic overactive bladder. Can. J. Neurol. Sci. 2007;34:356-61.
Palatini P. Glomerular hyperfiltration: a marker of early renal damage in pre-diabetes and pre-hypertension. Nephrol. Dial. Transplant. 2012;27:1708-14.
Gupta J, Mitra N, Kanetsky PA et al. CRIC Study Investigators. Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin. J. Am. Soc. Nephrol. 2012 Dec;7(12):1938-46.
Downloads
Published
How to Cite
Issue
Section
Stats
Number of views and downloads: 627
Number of citations: 0
