Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

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Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

Al-Mashhadi, Ammar Nadhom Farman (författare): Uppsala universitet,Barnkirurgi

Checa, Antonio (författare): Karolinska Institutet

Wåhlin, Nils (författare): Karolinska Institute

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Nevéus, Tryggve, 1965- (författare): Uppsala universitet,Pediatrisk inflammationsforskning

Fossum, Magdalena (författare): Karolinska Institutet

Wheelock, Craig E. (författare): Karolinska Institutet

Karanikas, Birgitta (författare): Uppsala universitet,Barnkirurgi

Stenberg, Arne (författare): Uppsala universitet,Barnkirurgi

Persson, A. Erik G. (författare): Uppsala universitet,Institutionen för medicinsk cellbiologi

Carlström, Mattias (författare): Karolinska Institutet

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2017-12-01
2018
Engelska.
Ingår i: Pediatric nephrology (Berlin, West). - : Springer. - 0931-041X .- 1432-198X. ; 33:4, s. 639-649

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Abstract Ämnesord

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Objective Recent clinical studies have suggested an increased risk of elevated arterial pressure in patients with hydronephrosis. Animals with experimentally induced hydronephrosis develop hypertension, which is correlated to the degree of obstruction and increased oxidative stress. In this prospective study we investigated changes in arterial pressure, oxidative stress, and nitric oxide (NO) homeostasis following correction of hydronephrosis.Methods Ambulatory arterial pressure (24 h) was monitored in pediatric patients with hydronephrosis (n = 15) before and after surgical correction, and the measurements were compared with arterial pressure measurements in two control groups, i.e. healthy controls (n = 8) and operated controls (n = 8). Markers of oxidative stress and NO homeostasis were analyzed in matched urine and plasma samples.Results The preoperative mean arterial pressure was significantly higher in hydronephrotic patients [83 mmHg; 95% confidence interval (CI) 80–88 mmHg] than in healthy controls (74 mmHg; 95% CI 68–80 mmHg; p < 0.05), and surgical correction of ureteral obstruction reduced arterial pressure (76 mmHg; 95% CI 74–79 mmHg; p < 0.05). Markers of oxidative stress (i.e., 11- dehydroTXB2, PGF2α, 8-iso-PGF2α, 8,12-iso-iPF2α-VI) were significantly increased (p < 0.05) in patients with hydronephrosis compared with both control groups, and these were reduced following surgery (p < 0.05). Interestingly, there was a trend for increased NO synthase activity and signaling in hydronephrosis, which may indicate compensatory mechanism(s).Conclusion This study demonstrates increased arterial pressure and oxidative stress in children with hydronephrosis compared with healthy controls, which can be restored to normal levels by surgical correction of the obstruction. Once reference data on ambulatory blood pressure in this young age group become available, we hope cut-off values can be defined for deciding whether or not to correct hydronephrosis surgically.Keywords Blood pressure . Hydronephrosis . Hypertension . Nitric oxide . Oxidative stress . Ureteral obstruction

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Nyckelord

Blood pressure
Hydronephrosis
Hypertension
Nitric oxide
Oxidative stress
Ureteral obstruction

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Av författaren/redakt...: Al-Mashhadi, Amm ...; Checa, Antonio; Wåhlin, Nils; Nevéus, Tryggve, ...; Fossum, Magdalen ...; Wheelock, Craig ...; visa fler...; Karanikas, Birgi ...; Stenberg, Arne; Persson, A. Erik ...; Carlström, Matti ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Urologi och njur ...

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Av lärosätet: Uppsala universitet; Karolinska Institutet

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