Abstract
The study objective was to assess serum and urine fibronectin (FN) levels in children with vesicoureteral reflux (VUR) depending on reflux grade and urine osmolality. The study group (1) consisted of 54 VUR children, median age 4.28 (range 0.6–15) years: subgroup A, 19 children with grade II; subgroup B, 19 with grade III; and subgroup C, 16 with grade IV or V VUR. The control group (2) included 27 healthy children. The immunoenzymatic method enzyme immunoassay (EIA) was used to determine serum soluble and urine FN levels, with an osmometer to measure urinary osmolality. The median urine FN in VUR children was 224.1 (15.4–3537) ng/mg creatinine (Cr), compared with the control group: 137.9 (20.3–670.6) ng/mg Cr (p < 0.05), whereas median serum FN was 395.0 (13.0–779.9) ng/ml and 121.9 (25–345.1) ng/ml (p < 0.05), respectively. A detailed analysis showed that only in subgroup C was the level of urinary FN significantly higher than in the control group (p < 0.01). However, serum concentration was elevated in all VUR children (A–C) compared with controls (p < 0.01). Reduced osmolality, below 800 mOsm/kg H2O, was observed in subgroup C. Negative correlation between urinary osmolality and urinary FN was found (r = −0.426, p < 0.01). In children with VUR, serum FN increased with reflux grade, whereas its urinary level was elevated only in grade IV and V reflux with impaired urine concentration.
Similar content being viewed by others
References
Sargent MA (2000) What is the normal prevalence of vesicoureteral reflux? Pediatr Radiol 30:587–593
Gordon I, Barkovics M, Pindoria S, Cole TJ, Woolf AS (2003) Primary vesicoureteric reflux as a predictor of renal damage in children hospitalized with urinary tract infection: a systematic review and meta-analysis. J Am Soc Nephrol 14:739–744
Silva JM, Diniz JS, Silva AC, Azevedo MV, Pimenta MR, Oliveira EA (2006) Predictive factors of chronic kidney disease in severe vesicoureteral reflux. Pediatr Nephrol 21:1285–1292
International Reflux Study Committee (1981) Medical versus surgical treatment of primary vesicoureteral reflux: report of the International Reflux Study Committee. Pediatrics 67:392–400
Orellana P, Baquedano P, Rangarajan V, Zhao JH, Eng ND, Fettich J, Chaiwatanarat T, Sonmezoglu K, Kumar D, Park YH, Samuel AM, Sixt R, Bhatnagar V, Padhy AK (2004) Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux. Results of a coordinated research project. Pediatr Nephrol 19:1122–1126
Maruyama T, Hayashi Y, Nakane A, Sasaki S, Kohri K (2005) Intermittent pressure-loading increases transforming growth factor-beta-1 secretion from renal tubular epithelial cells: in vitro vesicoureteral reflux model. Urol Int 75:150–158
Solari V, Owen D, Puri P (2005) Association of transforming growth factor-beta 1 gene polymorphism with reflux nephropathy. J Urol 174:1609–1611
Abbate M, Zoja C, Rottoli D, Corna D, Tomasoni S, Remuzzi G (2002) Proximal tubular cells promote fibrogenesis by TGF-beta-1-mediated induction of peritubular myofibroblasts. Kidney Int 61:2066–2077
Wang J, Konda R, Sato H, Sakai K, Ito S, Orikasa S (2001) Clinical significance of urinary interleukin-6 in children with reflux nephropathy. J Urol 165:210–214
Schwarzbauer JE, Tamkun JW, Lemischka IR, Hynes RO (1993) Three different fibronectin mRNAs arise by alternative splicing within the coding region. Cell 35:421–431
Hynes RO, Yamada KMJ (1982) Fibronectins: multifunctional modular glycoproteins. Cell Biol 95:369–377
Proctor RA (1987) Fibronectin: a brief overview of its structure, function, and physiology. Rev Infect Dis 9(Suppl 4):S317–S321
Tamkun JW, Hynes RO (1983) Plasma fibronectin is synthesized and secreted by hepatocytes. J Biol Chem 258:4641–4647
Assmann KJ, Koene RA, Wetzels JF (1995) Familial glomerulonephritis characterized by massive deposits of fibronectin. Am J Kidney Dis 25:781–791
Gwinner W, Jackle-Meyer I, Stolte H (1983) Origin of urinary fibronectin. Lab Invest 69:250–255
Janssen U, Eitner F, Kunter U, Ostendorf T, Wolf G, Chaponnier C, Gabbiani G, Kerjaschki D, Floege J (2003) Extracellular actin impairs glomerular capillary repair in experimental mesangioproliferative glomerulonephritis. Nephron Exp Nephrol 93:158–167
Eikmans M, Baelde HJ, Hagen EC, Paul LC, Eilers PH, De Heer E, Bruijn JA (2003) Renal mRNA levels as prognostic tools in kidney diseases. J Am Soc Nephrol 14:899–907
Yoshioka K, Takemura T, Matsubara K, Miyamoto H, Akano N, Maki S (1987) Immunohistochemical studies of reflux nephropathy. The role of extracellular matrix, membrane attack complex, and immune cells in glomerular sclerosis. Am J Pathol 129:223–231
Chertin B, Solari V, Reen DJ, Farkas A, Puri P (2002) Up-regulation of angiotensin-converting enzyme (ACE) gene expression induces tubulointerstitial injury in reflux nephropathy. Pediatr Surg Int 18:635–639
Funabiki K (1989) Immunohistochemical analysis of extracellular components on the glomerular sclerosis in patients with glomerulonephritis and diabetic nephropathy. Nippon Jinzo Gakkai Shi 31:111–120
Kilis-Pstrusinska K, Wikiera-Magott I, Zwolinska D, Kopec W, Rzeszutko M (2002) Analysis of collagen IV and fibronectin in blood and urine in evaluation of nephrotic fibrosis in children with chronic glomerulonephritis. Med Sci Monit 8:CR713–CR719
Zhang YZ, Lee HS (1997) Quantitative changes in the glomerular basement membrane components in human membranous nephropathy. J Pathol 183:8–15
Alekseevskikh IuG, Bobkova VP, Razdol’kina TI, Gozalishvili TV, Sergeeva TV (1983) Fibronectin levels in blood, urine and kidney in children with kidney diseases. Arkh Patol 55:33–36
Solari V, Unemoto K, Piaseczna Piotrowska A, Puri P (2004) Increased expression of mast cells in reflux nephropathy. Pediatr Nephrol 19:157–163
Menendez V, Fernandez-Suarez A, Galan JA, Perez M, Garcia-Lopez F (2005) Diagnosis of bladder cancer by analysis of urinary fibronectin. Urology 65:284–289
Hegele A, Heidenreich A, Varga Z, von Knobloch R, Olbert P, Kropf J, Hofmann R (2003) Cellular fibronectin in patients with transitional cell carcinoma of the bladder. Urol Res 30:363–366
Kawauchi A, Watanabe H, Miyoshi K (1996) Early morning urine osmolality in nonenuretic and enuretic children. Pediatr Nephrol 10:696–698
Korzeniecka-Kozerska A, Zoch-Zwierz W, Wasilewska A (2005) Functional bladder capacity and urine osmolality in children with primary monosymptomatic nocturnal enuresis. Scand J Urol Nephrol 39:56–61
Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590
Goldraich IH, Goldraich NP, Ramos OL (1983) Classification of reflux nephropathy according to findings at DMSA renal scan. Eur J Pediatr 148:212–218
Chana RS, Martin J, Rahman EU, Wheeler DC (2003) Monocyte adhesion to mesangial matrix modulates cytokine and metalloproteinase production. Kidney Int 63:889–898
Jodal U, Smellie JM, Lax H, Hoyer PF (2006) Ten-year results of randomized treatment of children with severe vesicoureteral reflux. Final report of the International Reflux Study in Children. Pediatr Nephrol 21:785–792
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sabasińska, A., Zoch-Zwierz, W., Wasilewska, A. et al. Serum and urine fibronectin levels in children with vesicoureteral reflux. Pediatr Nephrol 22, 1173–1179 (2007). https://doi.org/10.1007/s00467-007-0477-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-007-0477-3