The role of epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria in children

The prevalence of dysmetabolic nephropathies in children is increasing from year to year, representing a significant problem in the overall structure of kidney diseases in pediatric age. Despite numerous studies dedicated to the issue of dysmetabolic nephropathies in children, the role of epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria remains insufficiently explored. Aim - to identify the leading epigenetic factors in the pathogenesis of dysmetabolic nephropathy with calcium oxalate crystalluria in children. Materials and methods. The data from the medical histories and outpatient records of 173 children were studied. Each child was additionally examined by narrow specialists of different profiles. Three groups were formed from the examined children: Group I - children with a complicated course of dysmetabolic nephropathy and a history of inflammatory processes in the urinary system (52 children), Group II - children with dysmetabolic nephropathy with persistent crystalluria (56 children) and the Control group, which included 65 healthy children. Results. The most significant prenatal epigenetic factors are the threat of early miscarriage, gestosis of the first and second halves of pregnancy, maternal anemia during pregnancy, parental alcohol and tobacco use, mother's work on computer during pregnancy, presence of maternal chronic diseases, parental exposure to industrial dust and noise, and heavy physical work of mother leading to fetal hypoxia. Conclusion. The most significant postnatal epigenetic factors influencing children's susceptibility to a more severe course of dysmetabolic nephropathy included low birth weight, early artificial feeding, frequent acute respiratory infections, atopic diathesis, and physiological jaundice in the first year of life, as well as the presence of concomitant diseases such as chronic tonsillitis, dental caries, frequent acute respiratory infections, chronic gastritis, atopy, and chronic cholecystitis later in life. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of these institutions. The informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.