İnvestigation of serum hyaluronic acid levels in patients with GN

Glomerulonephritis (GN) is a cluster of conditions characterised by inflammation in the filtering units of the kidney. GN may be primary; secondary to drugs, infections, tumours; systemic disease.GN and is a preventable cause of renal failure and cardiovascular risk. GN is treatable cause of morbidity and mortality. Early diagnosis, including referral to a specialist centre, is key to preventing irreversible damage. GN can be precisely identified by renal biopsy that is undertaken in specialist nephrology centres.GN may present with oedema or hypertension and impairment of excretory renal function; also in any patient with proteinuria with or without haematuri. GN categorised into several different pathological patterns. If GN is diagnosed, treatment can be aimed at: reducing symptoms and signs, preventing progressive loss of excretory renal function.In early phases of some GN, one also finds the glomerular tuft invaded by bonemarrow derived inflammatory cells, such as granulocytes, monocyte-macrophages, and less frequently, T cells and platelets. The release of various soluble mediators by these inflammatory cells (such as autacoids and polypeptide cytokines) is thought to induce proliferation and changes of the secretory phenotypes of glomerular cells.Damage to the glomeruli of the kidney in GN can cause various reactions of glomerular cells and changes of the extracellular matrix (ECM). In more protracted diseases, obvious ECM changes are found. In particular, it is the ECM of the mesangium that increases in extent, eventually leading to irreversible sclerotic changes of the glomerular tufts and to loss of glomerular function.Hyaluronan (HA ,hyaluronic acid) is a high molecular mass polysaccharide, composed of linear polymers of a repeating disaccharide structure of alternating glucuronic acid and N-acetylglucosamine. Hyaluronan has been assigned various physiological functions in the intercellular matrix, e.g. in water and plasma protein homeostasis. Hyaluronan production increases in proliferating cells and the polymer may play a role in mitosis. Hyaluronan seems to play an important role during development and differentiation and has other cell regulatory activities.In the kidney, HA is abundantly present as the main component of the renal inner medullary interstitium . HA in the kidney is upregulated during various renal inflammatory diseases.In this study, we aimed to investigate the value of hyaluronic acid levels, a non-invasive biochemical marker, for the evaluation of patients with GN.A total of 54 patients who had been admitted in Nephrology Clinics of Medical Faculty, Dicle University between june 2008 and december 2009, and 28 healty voluntary were included into this study.Patients with GN were grouped according to the levels of 24-hour urinary protein. Serum hyaluronic acid, serum albumin, serum creatinine, serum urea and BUN, MDRD, erythrocyte sedimentation rate, white blood cell, hemoglobin and thrombocyte levels were compared between the patient groups and control group.In conclusion, the results obtained in this study support the concept that the serum level of HA in the patient with GN, statistically higher than healty controle group (p<0,05).