Renal Doppler Diagnostics in Lead-, Nickel- and Manganese-Exposed Children

Introduction: Under the current unfavorable environmental conditions, chronic diseases of human systems, including the urinary system, having a protective function, are becoming more and more prevalent.

Objective: The aim of the study was to identify ultrasound criteria for early diagnostics of renal pathologies in children, who were exposed to metals of anthropogenic origin (lead, nickel, manganese). In order to achieve this aim, we have assessed renal hemodynamics in children with high blood metal levels. We have also identified a relationship between blood metal levels and an ultrasound examination of renal blood circulation as well as ultrasound criteria for the signs of early renal disorders in patients, exposed to the metals of anthropogenic origin (lead, nickel, manganese).

Materials and Methods: A total of 90 children with minor changes in uranalysis in their anamnesis were examined in this study. The children were divided into a study group (54 patients) and a control group (36 patients). All the patients underwent renal scanning, which was performed using a Toshiba Aplio XG ultrasound scanner (Japan) with a 7-14 MHz linear-array transducer and a 3-6 MHz curved array transducer from multiple views.

Results: We have found out that children with urine and blood samples, containing elevated levels of metals of anthropogenic origin (lead, nickel, manganese), typically demonstrate renal hemodynamic disorders, which can be detected by ultrasound diagnostic methods. The extent of hemodynamic changes was affected by the blood levels of lead, nickel and manganese.

Conclusion: We have determined Doppler ultrasound criteria for early diagnostics of renal pathologies in children with biological samples, containing increased levels of the metals of anthropogenic origin (lead, nickel, manganese). The criteria are poor blood circulation in color Doppler mapping in the subcapsular area (a qualitative assessment); a reduction in relative characteristics of blood circulation (RI < 0.6; PI < 1.1); the difference between the lower and upper bounds of RI value range from the arterial trunk to the peripheral arteries greater than 0.04-0.05. We have shown a true correlation between relative parameters of blood circulation which characterize renal vascular resistance and the blood levels of the metals (lead, nickel, manganese). We have determined high risks of inflammatory and abacterial diseases of the urinary system in children with blood and urine levels of lead, nickel and manganese, exceeding the reference concentrations by 1.5-1.7 fold, in environmentally unfavorable areas.

Author(s): Nina Zaitseva , Olga Ustinova , Olga Vozgoment , Alfiya Aminova , Alevtina Akatova , Yuliya Perlova , Irina Shtina

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