الفهرس 
AsthmaOnly 14 pages are availabe for public view
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Abstract
A ttention has been focused on asthma associated low-grade systemic inflammatory changes and its effect on different body systems. Focusing on renal system, asthma could induce subtle and early alterations in renal integrity including vascular, glomerular and tubular aspects. At present, the two primary reasons for kidney injury in patients with asthma are chronic hypoxia and increased oxidative stress as a result of chronic inflammation.
So, This Prospective follow up study aimed to investigate the presence of early kidney affection in asthmatic children including glomerular, tubular and vascular affection. And to investigate the relation between the studied renal markers and the clinical profile and pulmonary functions of the patients.
The study was conducted on 60 children; 30 asthmatics with clinically diagnosed asthma According with the GINA guidelines, and 30 apparently healthy subjects serving as control group.
Asthmatic children were recruited from Pediatric Chest Clinic during:
1. Acute asthma exacerbation.
2. After asthma exacerbation attack control during coming for follow up after 6 months.
The age of the asthmatic group ranged between 6-17 year with median of 10 years, and for the healthy control group 5-16 year with median 9 years. Asthmatic children were twenty males (66.7%) and ten females (33.3%) with male - female ratio was 2:1. Moderate asthmatics were 21 (70%) while severe asthmatics were 9 (30%) &controlled asthmatics were 16 (53.3%) while uncontrolled asthmatics were 14 (46.6%). The study was conducted at Children’s hospital, Ain Shams University during the period from December 2017 to April 2019.
All studied patients were subjected to the following:
Full medical history, through clinical examination, pulmonary functions for asthmatic patients and measurement of renal glomerular function using (blood urea nitrogen & serum creatinine& serum cystatine C), renal tubular function using (urinary creatinine & β2 microglobulin) and renal vascular function using (intrarenal resistive index and acceleration).
Collected data were reviewed, coded and entered PC where statistical analysis was done using SPSS (statistical package for social science) version 25.
The study revealed that:
• Childhood asthma could induce early alterations in the renal integrity including:
1. Affection of renal glomerular functions through increased serum cystatin C during acute asthma exacerbation in comparison to control group.
2. Affection of renal tubular functions through increased urinary β2 microglobulin during both acute asthma exacerbation and follow up in comparison to control group.
3. Affection of renal vascular functions through decreased intrarenal acceleration in uncontrolled asthmatics in
comparison to controlled asthmatics.
• Childhood asthma has earlier renal tubular than glomerular affection through sustained elevation of urinary β2 microglobulin in acute asthma exacerbation and follow up in comparison to elevated serum cystatin C only in asthma exacerbation.
• There is a predicted parallel vascular affection in asthmatic children who had glomerular injury, which reflected by positive correlation between intrarenal vascular resistive index and serum cystatin C level.
• Uncontrolled asthma could induce renal vascular injury, which reflected by decreased intrarenal acceleration in uncontrolled asthmatics.
• Blood urea nitrogen and serum creatinine are non-sensitive early markers in detection of renal glomerular affection in childhood asthma
CONCULSION
I
n conclusion, on studying systemic effect of asthma on the renal system, we found that:
Childhood asthma could induce early alterations in the renal integrity including renal glomerular, tubular and vascular functions especially in uncontrolled asthma and asthma exacerbations.