Abstract Ref Number = APCP1067
SERUM MALONDIALDEHYDE LEVEL IN EARLY DIAGNOSED NEPHROTIC SYNDROME AND FINISHED THERAPY AND ITS CORRELATION WITH OTHER LABORATORY PARAMETERS
RISKA HABRIEL RUSLIE,Oke Rina Ramayani,Rosmayanti Syafriani Siregar,Beatrix Siregar,Yazid Dimyati
Nephrology Division Department of Child Health Universitas Sumatera Utara Nephrology Division, Department of Child Health, Universitas Sumatera Utara Neurology Division, Department of Child Health, Universitas Sumatera Utara
Background : Accumulation of free radicals were responsible for the nephrosis injury, which involved in the pathogenesis of nephrotic syndrome (NS). High stress oxidative in NS might impaired response to corticosteroid treatment and increased relapse risk. Free radical is indirectly assessed by measurement of malondialdehyde (MDA), waste product of lipid peroxidation. The objectives of this study were to determine the difference of MDA levels in early diagnosed NS patients and finished therapy, correlation of MDA levels and laboratory parameters (albumin, urine albumin creatinine ratio/UACR, and total cholesterol), and also accuracy of those laboratory parameters in predicting high MDA level.
Material : A case control study on 28 early diagnosed NS patients (within first week of full dose corticosteroid) and 22 finished therapy NS patients (within first week after discontinuing therapy) that were admitted to Pediatric Nephrology Division, Adam Malik General Hospital, Medan from April to December 2017. Diagnosis criteria for NS are massive proteinuria with UACR >2mg/g, hypoalbuminemia ?2.5g/dL, generalized edema, with or without hypercholesterolemia. Serum MDA level were examined using an HPLC MDA kit. Mann Whitney U test, Spearman correlation, and ROC curve were performed using SPSS with 95% CI. P value <0.05 was considered statistically significant.
Results : MDA level was significantly higher in early diagnosed NS than finished therapy patients (p<0.001). There was a significant negative correlation between MDA and albumin levels (r=-0.503, p=0.004), and significant positive correlations between MDA levels with UACR (r=0.497, p<0.001) and total cholesterol levels (r=0.592, p<0.001). Serum albumin levels <2.43g/dL, UACR >1.8 mg/g, total cholesterol >220mg/dL were able to predict high MDA levels in NS patients with good accuracy (80%, 78%, and 84%, respectively).
Conclusions : Free radical was significantly higher in early diagnosed NS than those who finished therapy, so antioxidant supplementation might be considered. Low albumin, high UACR and total cholesterol levels were able to predict high MDA level in NS patients.
Keywords: nephrotic syndrome free radicals malondialdehyde oxidative stress