Pediatrics & Therapeutics
Open Access

Abstract

Secondary oxalate nephropathy in children with allergic pathology

Magina Artikova

Introduction & Aim: In recent years, there has been a steady increase in the number of children with hyperoxaluria along with various allergic pathologies. Hyperoxaluria is the main factor leading to the development of nephrolithiasis. The hyperoxaluria in children can be asymptomatic for a long time, leading to secondary oxalate nephropathy, urolithiasis and chronic kidney disease. Our objective was to assess the clinical features of patients with hyperoxaluria in combination with allergic pathology.
Materials & Methods: We observed 103 patients with secondary oxalate nephropathy (hyperoxaluria) aged 6 months to 7 years with a glomerular filtration rate above 60 ml/min. The median age of the patients was 3.48. All children underwent a general clinical examination: Oxalates in daily urine were determined, urine flow cytometry was performed, microalbumin in urine was determined, a general blood test, biochemical blood tests, determination of immunoglobulin E in the blood, bacteriological examination of feces for quantitative and qualitative composition of microflora were performed.
Results: Food allergies were identified in 18% of cases (9 patients), 7.7% of cases (8 patients) had urticaria, 23% (24 patients) had vasomotor rhinitis, 8.73% (9 patients) had atopic dermatitis. It was found that 28 children (27%) had a combination of allergic pathologies, such as vasomotor rhinitis and urticaria, atopic dermatitis and vasomotor rhinitis. In children with an existing allergic pathology, the clinical course of oxalate nephropathy was more pronounced than in children without allergic pathology. It was found that children with an aggravated allergic history were part of the often ill children group and therefore received frequent therapy with antibiotics in which the degree of hyperoxaluria was more pronounced, characterized by microalbuminuria and microhematuria.
Conclusion: The study showed that among children with hyperoxaluria a large number of children with allergic pathology were identified. Allergic pathology as a premorbid background often determines the peculiarity of the course of secondary oxalate nephropathy. In addition, the use of antibiotic therapy leads to a violation of the intestinal microbiome, which increases the risk of nephrolithiasis. Thus, allergopathology along with antibiotic therapy can be considered as risk factors for the adverse course of secondary oxalate nephropathy.