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Open Access 01-04-2018 | Original Article

Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

Authors: Ammar Al-Mashhadi, Antonio Checa, Nils Wåhlin, Tryggve Neveus, Magdalena Fossum, Craig E. Wheelock, Birgitta Karanikas, Arne Stenberg, A. Erik G. Persson, Mattias Carlstrom

Published in: Pediatric Nephrology | Issue 4/2018

Abstract

Objective

Recent clinical studies have suggested an increased risk of elevated arterial pressure in patients with hydronephrosis. Animals with experimentally induced hydronephrosis develop hypertension, which is correlated to the degree of obstruction and increased oxidative stress. In this prospective study we investigated changes in arterial pressure, oxidative stress, and nitric oxide (NO) homeostasis following correction of hydronephrosis.

Methods

Ambulatory arterial pressure (24 h) was monitored in pediatric patients with hydronephrosis (n = 15) before and after surgical correction, and the measurements were compared with arterial pressure measurements in two control groups, i.e. healthy controls (n = 8) and operated controls (n = 8). Markers of oxidative stress and NO homeostasis were analyzed in matched urine and plasma samples.

Results

The preoperative mean arterial pressure was significantly higher in hydronephrotic patients [83 mmHg; 95% confidence interval (CI) 80–88 mmHg] than in healthy controls (74 mmHg; 95% CI 68–80 mmHg; p < 0.05), and surgical correction of ureteral obstruction reduced arterial pressure (76 mmHg; 95% CI 74–79 mmHg; p < 0.05). Markers of oxidative stress (i.e., 11-dehydroTXB₂, PGF_2α, 8-iso-PGF_2α, 8,12-iso-iPF_2α-VI) were significantly increased (p < 0.05) in patients with hydronephrosis compared with both control groups, and these were reduced following surgery (p < 0.05). Interestingly, there was a trend for increased NO synthase activity and signaling in hydronephrosis, which may indicate compensatory mechanism(s).

Conclusion

This study demonstrates increased arterial pressure and oxidative stress in children with hydronephrosis compared with healthy controls, which can be restored to normal levels by surgical correction of the obstruction. Once reference data on ambulatory blood pressure in this young age group become available, we hope cut-off values can be defined for deciding whether or not to correct hydronephrosis surgically.

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Title: Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children
Authors: Ammar Al-Mashhadi
Antonio Checa
Nils Wåhlin
Tryggve Neveus
Magdalena Fossum
Craig E. Wheelock
Birgitta Karanikas
Arne Stenberg
A. Erik G. Persson
Mattias Carlstrom
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 4/2018
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3848-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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