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Chronic kidney disease (CKD) can be defined as the progressive loss of renal function, characterized by a decreased glomerular filtration rate (GFR). The etiology of CKD in childhood is mainly associated with congenital anomalies of the kidneys and urinary tract (CAKUT) and with glomerular diseases. The goal of this study was to investigate the hemostasis and oxidative stress in pediatric CKD of different etiologies. Fifty-four CKD children and adolescents and 52 controls were enrolled in this study. The evaluation of hemostasis was carried out by determination of D-dimer (D-Di) and plasminogen activator inhibitor (PAI-1) plasma levels, while oxidative stress was evaluated by thiobarbituric acid reactive substance (TBARS) levels, protein carbonyl content, plasma antioxidant capacity (MTT), and ascorbate. The D-Di was increased in CAKUT stage 3 or 4 patients compared with those with glomerular disease. PAI-1 was increased in patients with glomerular disease compared with CAKUT. Carbonyl protein content was higher in the control group compared with glomerular disease stage 3 or 4 patients. Our findings showed that the reduction in GFR is associated with a state of hypercoagulability. The analysis of integrated networks showed an expansion of connections among hemostatic and oxidative stress markers in CKD children and adolescents compared with controls.

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A avaliação da função renal é de extrema importância na prática clínica, tanto para o diagnóstico quanto para e prognóstico e monitoração das doenças renais. Neste contexto, aparticipação do laboratório é de grande importância, uma vez que a maior parte das doenças renais só se manifesta clinicamente quando mais de 50% a 75% da função renal estácomprometida. O desenvolvimento de novos biomarcadores para diagnóstico precoce, estratificação de risco, prognóstico de lesão renal tem sido um dos principais alvos das pesquisas envolvendo o sistema renal. Dessa forma, diversos novos biomarcadores, tais como lipocalina associada à gelatinase de neutrófilos (NGAL), cistatina C, molécula-1 de lesão renal (KIM-1), interleucina-18 (IL-18), enzimas urinárias tubulares e proteínas de baixo peso molecular, dentre outros, têm sido propostos para diagnosticar /monitorar as doenças renais agudas e crônicas. Este estudo visa discutir aspectos associados aos principais biomarcadores utilizados na rotina laboratorial para diagnóstico, prognóstico e acompanhamento do paciente com disfunção renal, bem como apresentar novos marcadores que se destacam na literatura recente e que podem ser promissores na prática clínica

The assessment of renal function is very important in clinical practice, both for diagnosis and for prognosis and monitoring of renal diseases. In this context, the role of the laboratory is of great importance, since most of the kidney disease manifests itself clinically only when more than 50 to 75% of kidney function is compromised. The development of new biomarkers for early diagnosis, risk stratification, prognosis of renal injury has been a major focus of research involving the renal system. Thus, several new biomarkers, such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL18) and low-molecular weight proteins and enzymes, and others, have been proposed to diagnose/monitoring acute and chronic renal diseases. The aim of this study is to discuss aspects related to the main biomarkers used in routine laboratory tests for diagnosis, prognosis and monitoring of patients with renal dysfunction, as well as provide new markers that stand out in the recent literature, and that may be promising in clinical practice

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BACKGROUND: Asymmetric Dimethylarginine (ADMA) is a modified amino acid formed when intracellular arginine is methylated by methyltransferases that are widely distributed throughout the body. Nitric oxide (NO) is produced from l-arginine in a reaction catalyzed by three distinct isoforms of NO synthase (NOS). NO has emerged as a mediator involved in maintenance of vascular tonus, blood pressure regulation, inhibition of platelet aggregation, leukocyte and endothelial cell interaction and vascular permeability. ADMA is an important inhibitor that competes with NOS and compromises NO synthesis. OBJECTIVE: This review aims to compile articles involving renal and cardiovascular diseases in which plasma ADMA was assessed in order to clarify its role in these diseases. CONCLUSION: Although current knowledge suggests that ADMA has a role in the onset of cardiovascular and renal diseases, its actions are poorly understood. Clarifying its biochemical mechanisms is essential for improving disease management and promoting better quality of life for these patients.

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