| Abstract: |
The current study was designated to investigate the relationship between plasma VEGF, urinary VEGF, and urinary VEGF ratio with both proteinuria and steroid responsiveness in children with nephrotic syndrome.The study included 32 nephrotic patients, mean age of patients was (6.3±2.99) years, ranging from (2-14) years, (62.5%) were male (20 cases), (37.5%) were female (12 cases).Patients were subdivided into four groups. Group (I) included seven newly diagnosed cases, which represented 21.9%. Group (II) included seven steroid resistant cases, which represented 21.9%. Group (III) included eight steroid relapse cases, which represented 25%. Group (IV) included ten steroid remission cases, which represented 31.2%.We included a control group represented by eight age and sex matched healthy children in our study.Children in the study were subjected to; Recording body weight, Thorough history taking, laying stress on symptoms of nephrotic syndrome and its complications, detailed information about drug therapy particularly response to steroids.Clinical examination was done to confirm the diagnosis and to detect signs of remission or relapses, measurement of arterial blood pressure and looking for edema.Laboratory investigations were done to verify the diagnosis and the disease state: Complete blood picture, Complete urine analysis, Quantitative estimation of urinary protein by measuring urinary protein and urinary creatinine in a random urine sample, Serum cholesterol and serum creatinine, Serum protein and.Other laboratory investigations performed to monitor Circulating plasma vascular endothelial growth factor (VEGF), Urinary vascular endothelial growth factor (VEGF), Ratio of urinary vascular endothelial growth factor (VEGF) (U VGEF / U Creatinine) was calculated.The median value of urinary protein / urinary creatinine ratio for cases was (1.965), and (0.045) for controls. It showed a significant difference.Plasma VEGF measured between cases and control groups, showed no significant difference between them (p > 0.05), but showed significant differences between steroid relapse cases when compared with steroid remission cases and controls. A significant difference between steroid resistant and steroid remission cases was also detected (p < 0.05).Urinary VEGF was also measured between cases and control groups and showed no significant difference (p > 0.05), but there were significant differences between newly diagnosed and steroid relapse cases when compared with steroid remission cases and controls.Urinary VEGF ratio was calculated between cases and controls and showed a significant difference. There were significant differences between newly diagnosed, steroid resistant, and steroid relapse cases when compared with remission cases or controls.We detected a significant positive correlation between plasma VEGF and urinary VEGF ratio, plasma VEGF and urinary protein / urinary creatinine ratio in cases.We detected a significant positive correlation between urinary VEGF ratio and urinary protein / urinary creatinine ratio.Finally, we concluded that, childhood nephrotic syndrome is associated with an increase in urinary VEGF ratio in all active proteinuric nephrotic patients. It is also associated with an increase in plasma VEGF in steroid relapse and steroid resistant cases.Accordingly, we conclude that VEGF has a direct relation to proteinuria and steroid responsiveness in childhood nephrotic syndrome
|
|
|