Tumor necrosis factor alfa (TNFα) and alfa-Klotho (αKL) in children and adolescents with chronic kidney disease (CKD).

Introduction: Chronic kidney disease (CKD) in children, despite the progress in science and medical technology, is still a serious challenge. Early CKD detection gives a chance for immediate therapeutic intervention and lowering the progression of the disease. According to several publications indicating the possible use of alfa-Klotho (αKL) and Tumor Necrosis Factor alfa (TNFα) for the early detection of the disease in adults, an attempt was made to evaluate their usefulness in the pediatric population. Material and Methods: Study group consisted of 42 patients with CKD with the mean age of 10,7 years (18 girls and 24 boys). Control group involved 21 healthy children with the mean age of 8,4 years (11 girls and 10 boys). Anthropometrical parameters and blood pressure were taken, routine biochemical tests were performed in the whole group. The concentration of TNFα and αKL in serum and urine was determined by enzyme immunoassay. Results: Children from the CKD group showed statistically significant difference in serum TNFα and αKL in comparison to the control group. There was no significant relation of evaluated markers to sex, presence of hypertension or proteinuria in children. Mean αKL serum concentration was higher in patients on dialysis compared to the group of conservatively treated children, whereas the values of TNFα in serum and urine as well as the αKL in urine did not differ significantly in these groups. Significant positive correlation was found between serum αKL concentration and serum creatinine, but there was no other correlation between serum αKL or TNFα concentration and any of measured anthropometric and laboratory parameters. Conclusions: Serum TNFα and αKL levels in children with chronic kidney disease although being statistically different comparing to the healthy children group, showed no correlation to the most parameters used for chronic kidney disease evaluation except serum αKL and creatinine. Their usefulness in the early detection of kidney dysfunction in children was not proven.