Early renal involvement in children with cystic fibrosis.

Objective: Children with Cystic Fibrosis are in danger of acute kidney injury and the development of chronic renal disease due to presence of CFTR gene in the renal tubules as well as exposure to multiple potentially nephrotoxic agents including aminoglycosides, Ciprofloxacin, NSAIDs, frequently used in those patients. Our aim is early detection of renal impairment in children with CF and hence we can do careful monitoring, close follow up and adjustment of medications. Methods: Fifty patients with CF(aged 1-11) years were enrolled from the CF unit Children Hospital Cairo University, Egypt. They were age and sex matched to forty healthy children as a control group. All patients are screened for renal affection by renal Ultrasound and by measuring urine analysis, kidney function tests, Fractional excretion of sodium FENa, β2 Microglobulin β2-MG, Kidney injury molecule KIM-1 in urine using ELISA technique. Results: Out of 50 children there are 30 patients (60%) have high levels of β2MG and 33 patients (66%) have high levels of KIM-1. There were significant differences between β2MG level and KIM-1 level in case and control children (P value Conclusion: This study confirms the presence of early renal impairment among CF patients. Further large scale studies in the different populations as well as correlation with the genetic mutations is highly recommended. Urinary KIM-1 is a sensitive tool in the early diagnosis of acute renal injury before conventional laboratory assays become deranged.