Çeşitli böbrek hastalığı olan çocuklarda gentamisinin, N-asetil-beta-D-glukozaminidazın, beta-2 mikroglobulinin, mikroalbuminin ve biyokimyasal parametrelerin değişimlerinin incelenmesi

Abstract

135 VII. SUMMARY STUDY OF GENTAMICIN, N-ACETYL-BETA-D-GLUCOSAMINIDASE, BETA-2 MICROGLOBULIN, MICROALBUMIN AND BIOCHEMICAL PARAMETERS CHANGES IN DIFFERENT PEDIATRIC KIDNEY DISEASES This study was conducted to study the importance of different biochemical parameters, N-acetyl-jS-D-glucosaminidase, beta-2 microglobu lin and microalbumin in early detection and monitoring of patients with different pediatric kidney diseases. Fifty-four pediatric patients with various kidney diseases were followed in this study: 20 patients with Acute glomerulonephritis, 8 pati ents with Nephrotic syndrome, 5 patients with Henoch-Schönlein nephritis and 21 patients with Urinary tract infections. The data indicate N-a- cetyl-/3-D-glucosaminidase and beta-2 microglobulin are good indicators for various kidney diseases compared to biochemical parameters and mic roalbumin. The level of N-acetyl-j3-D-glucosaminidase in urine measured colorimetrically and its level before treatment are significantly higher than control group (1.85±0. 30 U/L; 2.44±0.68 U/g urine creatinine). The urine level of N-acetyl-/J-D-glucosominidase before treatment were as follows (Mean+SD): Acute glomerulonephritis (7.88±6.64 U/L; 14.74±12.00 U/g136 urine creatinine), Nephrotic syndrome (15.51±8.92 U/L; 32.93+22.45 U/g urine creatinine), Henoch-Schönlein nephritis (8.62+2.25 U/L; 24. 94± 13.76 U/g urine creatinine), Urinary tract infection (6.94 + 4.08 U/L; 15.88+13.83 U/g urine creatinine). The urine level of beta-2 microglobulin measured by immunoradi- ometric assay method. The level of beta-2 microglobulin are significantly higher than control group (21.50±4.48 ng/ml, 29.52±6.78 ng/mg urine cre atinine). The urine level of beta-2 microglobulin before treatment were as follows (MeaniSD): Acute glomerulonephritis (54.55+38.06 ng/ml; 110.74±67.82 ng/mg urine creatinine), Nephrotic syndrome (235.00±150.99 ng/ml; 521.47+383.40 ng/mg urine creatinine). Henoch-Sc hönlein nephritis (42.40+8.98 ng/ml; 127.80178.31 ng/mg urine creatini ne), Urinary tract infection (120.23±80.20 ng/ml; 33.71±15.46 ng/mg uri ne creatinine). In this study the level of gentamicin monitored in 21 patients with urinary tract infection treated with gentamicin 5 mg/kg/I.M showed serum level within therapeutic level (2-10 /zg/ml). As a conclusion due to higher stability of N-acetyl-/î-D-glucosa- minidase in urine and absence of diurnal variation of excretion of N-a- cetyl-0-D-glucosaminidase suggest the analysis of N-acetyl-/?-D-glucosami- nidase in determination and following of pediatrics patients with different kidney disease better than beta-2 microglobulin. Also this stuy indicate the importance of monitoring of gentamicin level to prevent nephrotoxicity and ototoxicity in pediatric therapy.

135 VII. SUMMARY STUDY OF GENTAMICIN, N-ACETYL-BETA-D-GLUCOSAMINIDASE, BETA-2 MICROGLOBULIN, MICROALBUMIN AND BIOCHEMICAL PARAMETERS CHANGES IN DIFFERENT PEDIATRIC KIDNEY DISEASES This study was conducted to study the importance of different biochemical parameters, N-acetyl-jS-D-glucosaminidase, beta-2 microglobu lin and microalbumin in early detection and monitoring of patients with different pediatric kidney diseases. Fifty-four pediatric patients with various kidney diseases were followed in this study: 20 patients with Acute glomerulonephritis, 8 pati ents with Nephrotic syndrome, 5 patients with Henoch-Schönlein nephritis and 21 patients with Urinary tract infections. The data indicate N-a- cetyl-/3-D-glucosaminidase and beta-2 microglobulin are good indicators for various kidney diseases compared to biochemical parameters and mic roalbumin. The level of N-acetyl-j3-D-glucosaminidase in urine measured colorimetrically and its level before treatment are significantly higher than control group (1.85±0. 30 U/L; 2.44±0.68 U/g urine creatinine). The urine level of N-acetyl-/J-D-glucosominidase before treatment were as follows (Mean+SD): Acute glomerulonephritis (7.88±6.64 U/L; 14.74±12.00 U/g136 urine creatinine), Nephrotic syndrome (15.51±8.92 U/L; 32.93+22.45 U/g urine creatinine), Henoch-Schönlein nephritis (8.62+2.25 U/L; 24. 94± 13.76 U/g urine creatinine), Urinary tract infection (6.94 + 4.08 U/L; 15.88+13.83 U/g urine creatinine). The urine level of beta-2 microglobulin measured by immunoradi- ometric assay method. The level of beta-2 microglobulin are significantly higher than control group (21.50±4.48 ng/ml, 29.52±6.78 ng/mg urine cre atinine). The urine level of beta-2 microglobulin before treatment were as follows (MeaniSD): Acute glomerulonephritis (54.55+38.06 ng/ml; 110.74±67.82 ng/mg urine creatinine), Nephrotic syndrome (235.00±150.99 ng/ml; 521.47+383.40 ng/mg urine creatinine). Henoch-Sc hönlein nephritis (42.40+8.98 ng/ml; 127.80178.31 ng/mg urine creatini ne), Urinary tract infection (120.23±80.20 ng/ml; 33.71±15.46 ng/mg uri ne creatinine). In this study the level of gentamicin monitored in 21 patients with urinary tract infection treated with gentamicin 5 mg/kg/I.M showed serum level within therapeutic level (2-10 /zg/ml). As a conclusion due to higher stability of N-acetyl-/î-D-glucosa- minidase in urine and absence of diurnal variation of excretion of N-a- cetyl-0-D-glucosaminidase suggest the analysis of N-acetyl-/?-D-glucosami- nidase in determination and following of pediatrics patients with different kidney disease better than beta-2 microglobulin. Also this stuy indicate the importance of monitoring of gentamicin level to prevent nephrotoxicity and ototoxicity in pediatric therapy.