Interleukin-18 and NGAL in assessment of ESWL treatment safety in children with urolithiasis.

Urolithiasis is recurrent chronic disease and a complex nephro-urological problem. Currently it is diagnosed in very young children, even infants in the first quarter of life. Until recently the main method of treatment for stones, which for various reasons did not pass spontaneously, was open surgery. At present, the main method replacing open surgery is extracorporeal shock wave lithotripsy (ESWL). Usefulness of common known indicators of the renal function to assess the safety of ESWL procedure is evaluated and verified. The basic markers are serum creatinine, cystatin C, urea, glomerular filtration rate and albuminuria assessment. Unfortunately all these methods show little sensitivity in the case of acute injury processes. There are efforts to use new biomarkers of renal tubular activity, which include among others interleukin 18 (IL-18) and neutrophil gelatinase-associated lipocalin (NGAL). The aim of the study was to assess the safety of ESWL by means of albumin to creatinine ratio, serum cystatin C levels and concentration of two new markers: IL -18 and NGAL. Albumin to creatinine ratio (p = 0.28) and serum cystatin C (p = 0.63) collected before and 48 hours after ESWL did not show statistically significant differences. Similarly, both new markers (IL -18 and NGAL) showed no significant differences (urine IL -18 p = 0.31; serum NGAL p = 0.11; urine NGAL p = 0.29). In conclusion, serum cystatin C tests, urine albumin to creatinine ratio and new early markers of renal tubular injury confirmed the safety of the extracorporeal shock wave lithotripsy (ESWL) and show that the procedure does not cause any episode of acute renal injury.

[Kidney tumor in 12-year-old girl--case study of the rare histopatologic form of neoplasm in children]. / Nowotwór nerki u 12-letniej dziewczynki--przypadek rzadko wystepujacej postaci histopatologicznej u dzieci.

The authors present an atypical case of MEST uncovered in 12-year-old girl diagnosed with recurrent pyuria and persistent albuminuria with concomitant hypertension. Urine changes persisted despite the antibiotics therapy and they were accompanied with aseptic urine cultures. While investigating these changes, USG, urography, CT and MRI were performed and these manifested tumor-like change in the right kidney. Right-side nefrectomy was performed. Microscopically MEST was found while infection was found in parenchyma. Mixed epithelial and stromal tumor is a very rare kidney tumor that occurs almost exclusively in perimenopausal women or women after a long-term estrogen replacement. There are only few cases of this tumor in premenarcheal girls described in literature.

[Spirometry evaluation of montelukast treatment in children with bronchial asthma]. / Spirometryczna ocena wyników leczenia montelukastem u dzieci chorych na astme oskrzelowa.

Difficulties associated with the management of asthma were the cause of using the leukotriene antagonists. There was performed a randomised group of 31 children aged 6-18 y (mean 12 yrs., 10 girls and 21 boys) with persistent asthma and poor asthma control. Montelukast was administered once daily, 5-10 mg depended of the age of the patients. This treatment was conducted for three months. Montelukast significantly improved pulmonary lung function (as measured by spirometry). Another effect of montelukast treatment was possibility the reduction beta 2-agonist use and the required dose of inhaled corticosteroids.