Enzymological Studies of the Functional State of the Kidney Parenchyma in Children of the Younger Age Group with Congenital Megaureter
Authors: Myhal Lyudmila , Nikulina Halyna , Petersburgsky Volodymyr , Kalishchuk Oles , Serbina Iryna 
Published: February 2024

The objective: to determine the activity levels of total N-acetyl-β-D-glucosaminidase (NAG), its heat-stable isoenzyme NAG B and β-galactosidase (β-Gal) as enzymological criteria of the functional state of the kidney parenchyma, in particular its tubular part, in the urine of younger children age group with congenital megaureter (MU) depending on the degree of suppression of the urodynamics of the upper urinary tract (UUT).
Materials and methods. Before reconstructive treatment 103 children aged 0.5 to 15 years with various clinical variants of congenital MU were examined. According to the degree of suppression of urodynamics of the UUT, the patients were divided into three groups: 1st group – 32 patients with I degree (initial degree), 2nd group – 41 children with II degree (medium one), 3rd group – 30 patients with III degree (expressed one). The control group included 25 practically healthy children.
Patients were divided into two subgroups by age. Subgroup “a” included 29 patients aged from 0.5 to 3 years (average age – 1.4±0.5 years), of which 9 patients were examined in the 1st group, 13 persons – in the 2nd group, in 3d group – 7 patients. Subgroup “b” included 74 children aged 4 to 15 years (average age – 8.3±1.5 years).
Enzymological activity of the morning portion of urine in patients was determined by the colorimetric method. Statistical processing of data was performed after analyzing the conformity of their distribution to normality.
Results. It was established that the total activity of NAG and the activity of NAG B in the urine of all patients with congenital MU with the I degree of suppression of urodynamics of the UUT, regardless of age, probably exceeded the average data of similar indicators in the control group (p<0.05–0.001). In children with congenital MU with II degree suppression of urodynamics of the UUT, regardless of age, a similar trend of changes in the activity levels of all the studied enzymes was determined, compared to patients of the 1st group (р<0.02–0.001). The total activity of NAG, the activity of NAG B and β-Gal in the urine of patients with III degree of suppression of urodynamics of the UUT probably exceeded similar indicators compared to patients of the 2nd group regardless of the age (p<0.001).
The results of the study showed that in patients with the I degree of suppression of urodynamics of the UUT between age groups there was no statistical probability of changes in the activity levels of the studied enzymes. In children under 3 years of age with III degree of inhibition of urodynamics of the UUT the levels of enzyme activity probably exceeded similar indicators in the group of patients of 3 years old and over (р<0.05–0.001). Enzyme activity levels of NAG and NAG B in the urine of patients under 3 years old with II degree of suppression of urodynamics of the UUT also statistically significantly exceeded the similar indicators of sick children over 3 years old (p<0.01).
Conclusions. The intensity of the increase in the urinary activity of NAG, its thermostable isoenzyme NAG B and β-Gal in patients under 3 years old compared to the group of patients over the age of 3 years growths with an increase in the degree of suppression of the urodynamics of the UUT, which should be taken into account during treatment.