Plasminogen activator inhibitor type-1 and interleukin-6 in haemolytic uraemic syndrome
A A Martin1, B L Woolven, S J Harris
1Renal Unit and Pediatric Intensive Care Unit, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Insights
Plasma levels of plasminogen activator inhibitor type-1 (PAI-1) and interleukin-6 (IL-6) were assessed in children with haemolytic uraemic syndrome (HUS). These markers did not definitively predict long-term kidney function outcomes in HUS patients.
Area of Science:
- Pediatric Nephrology
- Hematology
- Immunology
Background:
- Hemolytic uremic syndrome (HUS) is a significant cause of pediatric renal dysfunction.
- Identifying prognostic markers for HUS severity is crucial for predicting long-term sequelae.
- Glomerular filtration rate (GFR) is a key indicator of kidney function.
Purpose of the Study:
- To evaluate plasma levels of PAI-1 and IL-6 at HUS diagnosis as predictors of renal function outcome.
- To determine if these biomarkers can identify children at risk for poor long-term GFR.
Main Methods:
- Study included 14 children with diarrheal HUS.
- Plasma PAI-1 and IL-6 levels were measured at diagnosis.
- GFR was assessed at intervals post-discharge, with outcomes categorized at 12 months.
Main Results:
- Elevated PAI-1 was observed in 4/5 Poor Outcome and 4/9 Good Outcome children.
- Increased IL-6 was seen in 3/5 Poor Outcome and 3/9 Good Outcome children.
- Four children in the Poor Outcome group had compromised renal function at 36 months.
Conclusions:
- PAI-1 and IL-6 are elevated in some children with HUS at diagnosis.
- Neither PAI-1 nor IL-6 proved to be definitive prognostic markers for poor renal outcome 3 years later.
- Further research may be needed to identify reliable prognostic indicators for HUS.
Objective:
Because haemolytic uraemic syndrome (HUS) is an important cause of renal dysfunction in children, the availability of prognostic markers of disease severity could assist in identifying those at risk of developing long-term sequelae. The aim of this study was to test the hypothesis that plasma levels of plasminogen activator inhibitor type-1 (PAI-1) and interleukin-6 (IL-6) in children at the time of diagnosis of HUS would predict renal function outcome in terms of glomerular filtration rate (GFR).
Methodology:
Fourteen children suffering from diarrhoeal HUS were studied. Plasma samples were assayed for PAI-1 and IL-6, and GFR was measured at intervals after discharge from hospital. Twelve months following their recovery from HUS, the children were allocated to one of two outcome groups depending on whether GFR was above (Good Outcome, n = 9), or below (Poor Outcome, n = 5) 80 mL/min per 1.73 m2.
Results:
Elevated concentrations of PAI-1 were found in 4 of 5 Poor Outcome and 4 of 9 Good Outcome children. At the same time, increased concentrations of IL-6 were observed in 3 of 5 Poor Outcome and 3 of 9 Good Outcome children. Renal function continued to be compromised in four Poor Outcome children 36 months after diagnosis.
Conclusions:
Our data show that PAI-1 and IL-6 are elevated in the plasma of some children at the time of diagnosis of HUS, but that neither is a definitive prognostic marker of poor outcome 3 years later.
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