Effect Of Integrated Traditional Chinese And Western Medicine On Urine AQP2?AQP4 And AQP11 In Children With Primary Nephrotic Syndrome

ObjectiveTo observe the changes of urinary aquaporin-2(AQP2),aquaporin-4(AQP4)and aquaporin-11(AQP11)before and after treatment in children with primary nephrotic syndrome(PNS)treated by integrated traditional Chinese and Western medicine,in order to further improve the pathogenesis of PNS in children and clarify the the mechanism of treatment of integrated traditional Chinese and Western medicine in the treatment of children's primary nephrotic syndrome(simple type),and then to improve the clinical efficacy of children's PNS.MethodsTwenty children with PNS(simple type)were selected as the treatment group and 20 healthy children as the control group from People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine and the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine.The treatment group were treated with hormone combined with traditional Chinese medicine Shenkangling,and the levels of urinary AQP2,AQP4 and AQP11 and serum albumin,serum cholesterol and 24-hour urinary protein in the treatment group were observed before and after treatment.Statistical analysis was performed by SPSS 25.0 statistical software.Results1.Compared with the control group before treatment,there was no significant difference in gender and age between the two groups(all P >0.05).The levels of AQP2 and AQP4 in urine of the treatment group were significantly higher than those of the control group(all P <0.01).There was no significant difference in the levels of urinary AQP11 between the treatment group and the control group(P>0.05).2.After 4 weeks of treatment,the levels of urinary AQP2 and AQP4 in the treatment group were significantly lower than those before treatment(all P <0.01),and there was no significant difference in the levels of AQP11(P>0.05).Compared with the control group,the level of urinary AQP4 was higher than that in the control group(P<0.05),and there was no significant change in the levels of urinary AQP2 and AQP11(all P >0.05).The levels of 24-hour urinary protein and serum cholesterol were significantly decreased than those before treatment(all P<0.01),and serum albumin were significantly increased(P<0.01).3.After 12 weeks of treatment,the levels of urinary AQP2 and AQP4 in the treatment group were significantly lower than those before treatment(all P <0.01),and there was no significant change in the levels of AQP11(P>0.5).Compared with treatment for 4 weeks,there was no significant difference in the levels of urinary AQP2,AQP4 and AQP11(all P >0.05).There was no significant difference in the levels of urinary AQP2,AQP4 and AQP11 between the treatment group and the control group(all P >0.05).The levels of 24-hour urinary protein and serum cholesterol were significantly decreased than those before treatment(all P<0.01),and serum albumin were significantly increased(P<0.01).4.After 12 weeks of treatment,18 children with PNS had complete remission and 2 children had partial remission.Conclusions1.The notable increase of the levels of urinary AQP2 and AQP4 in children with PNS suggested that AQP2 and AQP4 may be involved in the pathogenesis of PNS in children.It may be an important factor leading to increased renal tubular reabsorption causing water-sodium retention.There was no significant difference in the levels of urinary AQP11 between the treatment group and the control group before and after the treatment.Therefore,the effect of integrated traditional Chinese and western medicine on the expression of AQP11 cannot be determined temporarily nor whether AQP11 plays a key role in PNS water-sodium retention.2.The levels of urinary AQP2 and AQP4 decreased significantly after treatment with integrated traditional Chinese and Western medicine,indicated that the treatment of PNS(simple type)in children by integrated traditional Chinese and Western medicine may be effective by reducing the levels of urinary AQP2 and AQP4.3.Integrative traditional Chinese and Western medicine treatment of PNS(simple type)in children can significantly improve the serum albumin,reduce serum cholesterol 24-hour urinary protein.18 children with PNS had completed remission and 2 children had partial remission.