RESUMO
The most common cause of fever in case of anomalies of the urinary system is pyelonephritis (PN). Despite the fact that an intensive search for informative clinical and laboratory markers of PN in children is being conducted in recent years, this problem remains unresolved. Objective - to examine the content of organ-specific enzymes (neutral α-glucosidase (NAG), L-alanine aminopeptidase (AAP), γ-glutamyltranspeptidase (GGTP) in urine and galectin 3 (Gal -3), C-reactive protein (CPR) in blood serum. A prospective, comprehensive clinical and laboratory-instrumental examination was performed in 75 children under the age of 1. The activity of organ-specific enzymes (NAG, AAP, GGTP) in urine and CPR, Gal-3 in the serum of blood were estimated as markers of proximal tubules' damage. The majority (62.99 ± 5.33%) of hospitalized children with febrile temperature and urine changes were diagnosed with PN, which often arose with underlying congenital malformations of the urinary tract. Among children with PN underlaying with VUR, the II and III grades of activity were significantly more frequent. An increase of the level of the enzymes in the urine is observed in the active phase of PN, which correlated with the level of leukocyturia and the level of CRP. During the inactive phase of PN with VUR, the level of enzymes was also higher than the one in children with PN without VUR. High values of Gal-3 were detected in case of underlying VUR, which increased together with increased activity and duration of the inflammatory process in kidneys and correlated with the level of CRP. The Gal-3 can be used for an early diagnosis of fibrotic changes of the renal parenchyma in adolescent children with PN and underlying VUR.
