Early detection of tubulo-interstitial kidney disease in children using highly discriminating sds-gel electrophoresis

Abstract EN

Tubulo-interstitial kidney disease is characterized by moderate proteinuria < 1 g / day of low molecular weight proteins in range of MW 10.000-50.000.

Even in the physiological proteinuria of < 150 mg / day, tubulo-interstitial kidney disease may exist.

Using optimized sodium dodecyl sulfate polyacrylamid gel electrophoresis (SDS-PAGE) according to the method of Melzer, even in proteinuria of less than 150 mg / day all relevant proteins for diagnosis of glomerular or tubulo-interstitial kidney disease can be detected.

This study evaluates the tubulo-interstitial kidney disease due to polychemotherapy for different types of cancer in 115 children and in 16 children with pyelo-ureteral junction obstruction.

Fifty-two and 63 children were followed up during and after chemotherapy, respectively.

During therapy, renal damage was recorded in 43 % of patients with leukemia, 56 % with nephroblastoma, and 79 % with other tumors.

Tubular protein patterns were seen up to three years after termination of chemotherapy (25 % in acute lymphoplastic leukemia, 35 % in nephroblastoma and 62 % in other tumors).

Patients with persistent complete tubular proteinuria or mixed glomerular / tubular proteinuria were found to have a high risk for irreversible renal failure.

Children with congenital pyelo-ureteral junction obstruction could also be classified according to SDS-PAGE protein patterns.

Patients without parenchymal lesions did not need surgery.

Most of those with pathologic findings in SDS-PAGE exhibited partial or complete remission after surgery.

The highly discriminating SDS-PAGE permits a rapid, sensitive, reproducible, and reliable analysis of urine proteins for diagnosis and follow-up of all kinds of congenital or acquired renal parenchymal kidney diseases.