GENOMIC INSTABILITY IN A CASE WITH CHRONIC OBSTRUCTIVE UROPATHY AND END-STAGE RENAL FAILURE

In Obstructive Uropathy normal urine flow is impeded because of structural and functional urinary tract abnormalities. Sustained obstruction decreases renal blood circulation and glomerular filtration rate accompanied by atrophy and apoptosis of the renal tubules resulting in irreversible kidney damage, inflammation and oxidative stress with progression to end-stage renal disease (ESRD) which requires dialysis therapy. The latter can also induce oxidative stress from mechanical stress exerted by the interaction of the blood with the dialysate across the dialyzer membrane. The effect of oxidative stress on biomolecules including DNA can occur via oxidation. As genetic damage studies on cases with uropathy and associated complications have not come to attention, peripheral blood of a 15 y-old male on hemodialysis presenting with chronic obstructive uropathy and ESRD was investigated for basal and oxidative DNA damage using the comet assay. Basal (2.35x) as well as oxidative DNA damage (~12x) was higher compared to levels in an age-matched healthy male. Lipid peroxidation assessed as Malondialdehyde (MDA) levels was also increased (3.64x) as were triglyceride levels. These findings on genetic damage and oxidative stress in obstructive uropathy and kidney disease mark early lesions which can translate to malignancy if unrepaired.