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Acute pyelonephritis (APN) is the most severe infection in children causing scar formation as a result of
inflammatory and oxidative/nitrosative stress processes. This time-course study was design to determine the progression of APN
on oxidative/nitrosative stress, and to correlate them with renal structure.
Materials and Methods:
Fifty rats were divided into five groups of ten rats each. Eight rats in each group underwent APN
procedure. The other two rats in each group served as sham-operated control group. APN was induced by injection of 0.1 ml
freshly prepared E.Coli solution into the both kidneys. The rats in each group were evaluated after 1, 3, 7, 14 and 42 days of
APN procedure, respectively. At the end of the experimental period, trunk blood was collected for biochemical analyses and
both kidneys were harvested for antioxidant enzyme activity (superoxide dismutase (SOD) and gluthation peroxidase (GPx)),
oxidative stress parameters tissue lipid peroxidation (MDA) and protein carbonyl content (PCC), nitrosative stress (NOx),
hydroxyl prolin (HP) level and histopathologic examination.
Both oxidative/nitrosative stress parameters and antioxidant enzyme activities increased progressively, but after 14th
day markedly decreased. Serum procalcitonin level to evaluate the bacterial infections and serum neopterine level to evaluate
immunologically induced oxidative stress increased progressively, particularly after 3th day, and then decreased after 14th day
to control values. Tissue HP level was increased progressively throughout the experimental period suggesting increased scar
formation which confirmed with histopathologic evaluation. Histopathologic evaluation also showed that injury score showed
a correlation with biochemical evaluation.
This study showed that there is a clear correlation between oxidative/nitrossative stress and renal scar formation
Ahmet Guven completed his pediatric surgery residency at Gulhane Military Medical Faculty, Ankara, Turkey. He is working as a clinician-researcher
in pediatric surgery at the Gulhane Military Medical Faculty, Ankara, Turkey. He has published more than 50 papers in reputed journals.
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