Study of Urinary Alpha Glutathione-S-Transferase (Alpha GST) in Children with Idiopathic Nephrotic Syndrome

Abstract

Background: Glomerulopathy associated with recurrent or persistent proteinuria may lead to progressive tubulointerstitial fibrosis. Early detec-tion of tubulointerstitial fibrosis may result in a more favorable outcome of chronic kidney disease (CKD) because nephroprotective treatment may be instituted in due course. One of the early markers of tubulointerstitial fibrosis is glutathione S-transferase (GST).The aim: The aim of this study was to determine urinary alpha-GST in children with idiopathic nephrotic syndrome (INS), either in remission or relapse. Material and methods: This case–control study included 40 children with primary nephrotic syndrome (NS), either in remission or relapse. Also, 40 healthy children, age- and sex-matched as controls, were selected from the outpatients and the pediatric nephrology unit of Al-Zahraa Hos-pital, Al-Azhar University. Urinary alpha-GST was investigated in the study groups on the same lines as that of routine investigations of INS. Results: Children with INS have significantly higher urinary GST either in remission or relapse, it was (5.23 ± 1.90) ng/mL, (5.32 ± 1.52) ng/mL respectively compared with healthy controls, it was (2.59 ± 1.12) ng/mL with (P = 0.001). A positive correlation between urinary alpha-GST and body weight BW, height, body mass index (BMI), white blood cells (WBCs) count, erythrocyte sedimentation rate, serum (cholesterol, triglycer-ide [TG]) level, blood urea nitrogen (BUN), and duration of the disease. Conclusion: Urinary alpha-GST was increased in children with NS even after remission, and it consequently led to oxidative stress and tubuloint-erstitial fibrosis. Nephroprotective treatment is recommended even in cases with INS, either in remission or relapse.