Nuclear Factor Kappa B (NF-kB) in Patients with Nephrotic Syndrome and Acute Renal Failure
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- Category: Vol. 79, December 2011
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Nuclear Factor Kappa B (NF-kB) in Patients with Nephrotic Syndrome and Acute Renal Failure,MONA HAMMADY, GAMAL SAADI, DINA ABDELLATIF and OLFAT SHAKER
Abstract
Background: In renal tissue injury, activation of the transcription factor NF-kB has a central role in the induction of proinflammatory genes expression, which are involved in the development of progressive renal inflammatory disease.
Aim of Work: The aim of our study was to evaluate the in situ expression of activated transcription factors NF-kB in renal biopsy sections of patients with nephrotic syndrome and acute renal failure and to study its role as a prognostic marker in proteinuric renal disease and acute renal failure by corre-lating its level with follow-up investigations of glomerulone-phritis after 3 months of treatment. The study included 30 patients with acute renal failure and nephrottic syndrome recruited from nephrology clinic in Kasr El-Aini Hospital and King Fahd unit during year 2007 till 2010. The patients were divided in 3 groups: Group I included 10 patients with idio-pathic nephrotic syndrome due to various glomerulonephrop-athies, group II included 10 patients presenting with nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS), group III included 10 patients presenting with acute renal failure (ARF).
Results: By comparing NF-kB in different groups it was highest in group 3 including patients with acute renal failure. Results showed no significant difference in relation to the two pathological entities that were found, acute interstitial nephritis (mean: 1102.7 density/mm2, ±SD 548.4) and acute tubular necrosis (ATN) (mean 1222.5, ±SD 432.0). On eval-uation of NF-kB levels in patients with nephrotic syndrome resulted in, that patients with membranoproliferative ( MPGN) had the highest levels, mean 795 density/mm2 SD±643.5, followed by the mesangioproliferative (MesPGN) patients, mean 598.7, SD±166.5. The lowest levels were found in patients with membranous nephropathy, mean 387.5 and SD±101.1. Taking the patients as one group before treatment, NF-kB showed significant positive correlation with, mean BP, the serum creatinine level (r=0.531, p=<0.01) and inverse correlation with proteinuria (r=0.415, p=<0.05). Logistic Regression analysis was done to evaluate the NF-kB as a predictor of outcome showing that NF-kB isn’t predictor for outcome in any group of the three.
Conclusion: The study shows that NF-kB levels are higher in patients with severe degrees of tubulointerstitial injury. Hence, it can be utilized as a marker of disease severity within this regard. Our results have also showed that, higher levels of NF-kB were detected MPGN more than other disease forms with the membranous nephropathy having the lowest levels. Our results didn’t prove NF-kB as a prognostic tool in glomerulonephritis and acute injury probably due to small numbers of patients.