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OBJECTIVES: Considering the relation between prematurity andasphyxia and also renal failure in neonates, the aim of this study was to determine the effect of aminophyllinein urine and serum indices of renal failure and consequently its prevention, in Premature Infants with asphyxia in Esfahan-lran. METHODS: In this descriptive clinical trial study, 22 preterm neonates diagnosed with perinatal asphyxia in neonatal ward of Shahid Beheshti hospital, during 2009.The participants were randomized in two intervention and placebo groups. They randomized to receive a single dose of aminophyiline (5 mg/kg) or placebo of 5% dextrose water for injection (5 cc/kg) during the first hour of life. Renal function was assessed by GFR, beta2-microglobulin (beta2M), N-acetyl-glucosaminidase (NAG) serum creatinine and electrolytes level measurement, during the 1st, 4th and 7th day of life, in two studied groups. The results compare between the two groups before and after intervention. RESULTS: Mean of urine output, was significantly higher in neonates who received aminophylline (P < 0.05).Mean of 132M and NAG 24 hours after intervention was not significant in the two groups of asphyxiated preterm neonates (P > 0.05).GFR was significantly higher in neonates who received aminophylline on 4th day of life (P < 0.05) and it had trend to be significantly high on 7th day (P = 0.05) and was not significantly high on 1st day (P > 0.05) comparing with control group. The most common pathophysiology of renal failure was prerenal. CONCLUSION: Aminophylline could prevent renal dysfunction in preterm neonates with asphyxia. Neonates who received aminophylin on the first day of life indicated a significant improvement in GFR and urine output.

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BACKGROUND: Vesicoureteral reflux (VUR) is a common finding in children with urinary tract infection (UTI), mostly diagnosed by voiding retrograde cystogram (VCUG). Children with VUR are at higher risk of renal damage with recurrent infections. Detecting VUR and renal scarring currently depends on imaging modalities with interventional invasive diagnostic methods. Noninvasive methods would greatly facilitate diagnosis and also help in identifying VUR in siblings of index cases who should be screened. Various imaging and biochemical methods with different specificity and sensitivity have been presented as substitute diagnostic tool for VCUG to identify VUR. Interleukin-8 (IL-8), a chemokine produced by damaged epithelial cells of the renal tract in response to inflammation, has been shown to increase during acute UTI. We have scarce data considering the cut point of urine IL-8 as a diagnostic method of VUR in children. The objective of this study was to assess the urine levels of IL-8 as a noninvasive marker of VUR in infants in the absence of a recent UTI episode. METHODS: This cross sectional study was conducted on28 patients with UTI and VUR (group 1), 28 patients with VUR and without UTI (group 2), and 28 healthy children/infants(control group)in St. Alzahra hospital, Esfahan, from January 2009 until March 2010.. Urine IL-8 level was measured for all children. The data was analyzed by SPSS soft ware version 17. The t-student test, ?2, and ANOVA were used as statistical method. RESULTS: The mean age of group 1, group 2 and control group were 4.3 +/- 2.9, 4 +/- 2.6 and 4 +/- 2.1 years respectively, p > 0.05. The mean level of IL-8 in group 1 was significantly higher than group 2 and control group 10 +/- 14.8 versus 6.5 +/- 8.4, and 2.9 +/- 4.5 respectively (P = 0.039). CONCLUSIONS: Although urinary IL-8 may be helpful in determining high grade VUR, but the results of this study showed that the sensitivity, specificity, PPV, and NPV of this marker were not satisfactory in cutoff point of 5 pg/pmol and other variables must be controlled.

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Several studies have evaluated cytoskeletal proteins as prognostic factors for some types of nephrotic syndrome. However, studies concerning children with FSGS are scarce. This study was done to evaluate the glomerular, tubular, and interstitial expression of vimentin, desmin, and alpha smooth muscle actin (α-SMA) in kidney specimens of children with FSGS. Clinical and histologic data of 31 children with FSGS were reviewed. Thirty one formalin-fixed, paraffin-embedded kidney biopsy sections (3 µm) were selected for immunohistochemical staining. Double immunohistochemistry using a microwave-based two-color staining was applied. The mean age at onset in male and female was 56.3 ± 41.4 and 78.0 ± 60.4 months, respectively. The duration of follow-up was 46.3 ± 56.5 months. Interstitial fibrosis and tubular atrophy were reported in 42% and 54% of the patients, respectively. The latest evaluated mean blood pressure was significantly correlated with the expression of both vimentin and α-SMA in the interstitium (P < 0.05). However, we were not able to demonstrate any cytoskeletal protein expression as an independent predictor for renal survival. Further studies with larger sample size and longer follow-up periods are warranted to investigate the prognostic values of other histopathologic features in pediatrics with FSGS.

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Cardiovascular morbidity and mortality are common in end stage renal disease (ESRD) patients. There is scarce data on carotid and bulb intima-media thickness (IMT-C and IMT-B) as an early marker of atherosclerosis and related factors in children on hemodialysis (HD) and peritoneal dialysis (PD). Since we did not have enough information about our patients, this study was carried on all ESRD children (hemodialysis and peritoneal dialysis) in a referral center. Data was collected from 16 ESRD children under 18 years with seven patients on PD and nine on HD. Lab tests and biochemical parameters including serum von Willebrand factor (vWF), homocystein, apo lipoprotein A, apo lipoprotein B and quantitative CRP were measured in fasting patients just before initiating dialysis. IMT-C and IMT-B were measured by gray scale ultrasound using 7.5 MHZ probe. The mean of age was 12.76+/-4.5 years. The mean duration of dialysis in HD and PD patients were not significantly different; 11.88+/-3.25 months and 10.14+/-2.4 months respectively. Mean of systolic blood pressure in HD group was significantly higher than PD group, 135.55+/-25.54 mmHg versus 121.42+/-12.14 mmHg, P<0.05. Significant differences among all following parameters in ESRD patients, with normal laboratory values, were clarified: cholesterol, triglycerides, apo A, apo B, quantitative CRP, VWF, homocystein and IMT-C. However, we could not demonstrate any difference between IMT-B in case and control group. After adjusting for age, partial correlation showed significant correlation between IMT-C and following factors: N-PTH and serum alkaline phosphatase. Longitudinal studies with large size samples are needed to clarify the contributing factors with intima-media thickness in ESRD children.