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A differentiated approach to prescribing anti-relapse therapy based on assessment of lipocalin-2 levels
https://doi.org/10.21508/1027-4065-2024-69-6-73-78
Abstract
Currently, there are no standardized guidelines on the need for and frequency of anti-relapse therapy in children with chronic secondary pyelonephritis.
Purpose. To assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (NGAL) measured as a ratio to urinary creatinine (NGAL/Cr), in predicting recurrence rates of chronic secondary pyelonephritis in children.
Material and methods. The study included 158 children aged 2 to 14 years with chronic secondary pyelonephritis, comprising 130 girls (82.3%) and 28 boys (17.7%). Children were divided into groups based on the presence and scheme of anti-relapse therapy (furazidine and/or phytopreparation BNO 1045). This article continues the authors’ research previously published in 2019, 2020, and 2023.
Results. A pre-treatment urinary NGAL/Cr level above 12 ng/mg in patients with recurrent secondary pyelonephritis allowed prediction of disease recurrence and supported the need for anti-relapse therapy. Adding the phytopreparation BNO 1045 to anti-relapse therapy for one month following a two-week furazidine course extended the relapse-free period from 13 to 16 months and reduced the recurrence risk by 1.9 times with therapy administered annually. Implementing this anti-relapse therapy every six months increased the median relapse-free period to 22 months, reducing recurrence risk by over fourfold.
Conclusion. The study demonstrates the predictive value of urinary NGAL/Cr levels before the initiation of antibacterial therapy, allowing assessment of relapse risk in secondary pyelonephritis. The findings support the necessity of anti-relapse therapy in children with chronic secondary pyelonephritis. Optimal remission extension was achieved with a combination therapy of furazidine and phytopreparation BNO 1045.
About the Authors
A. V. Eremeeva
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Moscow
V. V. Dlin
Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Moscow
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Review
For citations:
Eremeeva A.V., Dlin V.V. A differentiated approach to prescribing anti-relapse therapy based on assessment of lipocalin-2 levels. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2024;69(6):73-78. (In Russ.) https://doi.org/10.21508/1027-4065-2024-69-6-73-78
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