Pediatric Nephrology

, Volume 20, Issue 9, pp 1299–1305 | Cite as

Renal pathology in children with mitochondrial diseases

  • Elena Martín-Hernández
  • M. Teresa García-Silva
  • Julia Vara
  • Yolanda Campos
  • Ana Cabello
  • Rafael Muley
  • Pilar del Hoyo
  • Miguel Angel Martín
  • Joaquín Arenas
Original Article

Abstract

We studied renal involvement in 42 children with mitochondrial diseases (MDs). The diagnosis of MD was established by morphological, biochemical, and molecular genetic criteria. Renal disease was considered when patients had renal failure, nephrotic syndrome, Fanconi’s syndrome or any symptomatic renal alteration. Mild tubular disorder was established if they had abnormal laboratory findings with no apparent clinical symptom. Renal involvement was found in 21 children (50%), of whom 8 had an apparent clinical picture and 13 a mild tubular disorder. Five patients with renal disease showed Debré–Toni–Fanconi’s syndrome, 2 of them with decreased glomerular filtration rate (GFR). One case had nephrotic syndrome, another one presented decreased GFR, and the last one had a neurogenic bladder and bilateral hydronephrosis. Patients with mild renal disease showed tubular dysfunction with normal GFR. Renal involvement is frequent and present in about half of the children with MD. Thus, studies for evaluating kidney function should be performed on children with MD. Conversely, patients with tubulopathy of unknown origin or progressive renal disease should be investigated for the existence of MD, especially if associated with involvement of other organs or tissues. Southern blot analysis to search for large-scale mitochondrial DNA (mtDNA) rearrangements should be performed for patients with MD and kidney involvement.

Keywords

Mitochondrial Respiratory chain OXPHOS Renal involvement Kearns-Sayre syndrome Pearson syndrome 

Notes

Acknowledgements

We thank Dr de Meirleir and colleagues for their collaboration in the studies of case 4.

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Copyright information

© IPNA 2005

Authors and Affiliations

  • Elena Martín-Hernández
    • 1
  • M. Teresa García-Silva
    • 1
  • Julia Vara
    • 2
  • Yolanda Campos
    • 3
  • Ana Cabello
    • 4
  • Rafael Muley
    • 2
  • Pilar del Hoyo
    • 3
  • Miguel Angel Martín
    • 3
  • Joaquín Arenas
    • 3
  1. 1.Unidad de E. Mitocondriales—E. Metabólicas HereditariasDept. Pediatría, Hospital Doce de OctubreMadridSpain
  2. 2.NefrologíaDept. Pediatría, Hospital 12 de OctubreMadridSpain
  3. 3.Dept. de BioquímicaHospital 12 de OctubreMadridSpain
  4. 4.NeuropatologíaDept. de Anatomía Patológica, Hospital 12 de OctubreMadridSpain

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