Introduction: The kidney deterioration, which starts in childhood often leads to end-stage renal failure in the future. Therefore, searching for an early, sensitive, and specific biomarkers became a paramount for chronic kidney disease diagnosis. The aim of this study was the assessment of markers: KIM-1, FGF-23, NAG, NGAL, and uromodulin for diagnosis of preclinical phase of the disease in children. Patients and methods: 59 children (15 boys, 44 girls from 6 months to 17 years old) with kidney disorders, which had clinical indications for renoscintigraphy, were included in the study. All patients were divided depending on the result of renoscintigraphy (renal scarring vs normal kidney picture) and depending on the level of estimated glomerular filtration rate (glomerular hyperfiltration vs normal filtration rate). The concentration of uromoduline, KIM-1, FGF-23, NAG, and NGAL in serum and of NGAL and uromoduline in urine were measured in all studied groups. Results: The children with glomerular hyperfiltration had a statistically significantly higher serum values of FGF-23 and NGAL than the children with normal filtration rate ( P < .05). There were no statistically significant differences in serum concentrations of tested markers in children with renal scars in comparison to children with normal renal image. There was no statistically significant difference in the concentration of tested markers in urine. Conclusions: The study confirmed the possible usefulness of FGF-23 and NGAL in detecting the preclinical-stage of renal disease associated with glomerular hyperfiltration in children. The study do not allow to indicate markers, which could be useful in the early diagnosis of kidney damage visible in the scintigraphic examination.

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Chronic kidney disease is an irreversible kidney damage caused by structural or functional renal impairment and persisting for more than 3 months. It is usually accompanied by albuminuria, proteinuria, abnormal histopathological and imaging findings as well as a drop in glomerular filtration rate below 60 mL/min/1.73 m 2 . Due to the increasing number of patients, chronic kidney disease is referred to as "the epidemic of the 21 st century. " Early diagnosis allows for effective therapeutic intervention, which makes it possible to inhibit pathological processes and prevent disease in the future. Diagnostic difficulties in detecting early stages of chronic kidney disease are due to their asymptomatic nature and the fact that the markers widely used for renal function assessment are not very sensitive. Therefore, new, early, sensitive and specific markers of renal damage, whose introduction in everyday clinical practice would give a chance of a diagnosis at the very onset of the disease, before irreversible changes occur, are currently being sought. Although the results of scientific research are ambiguous, some of the candidate protein markers seem very promising. These include uromodulin, KIM-1, NGAL-1, NAG, FGF23, RBP4 and suPAR. The aim of the paper was to present a review of the latest research on the use of novel protein markers in the diagnosis of chronic kidney disease in paediatric and internal medicine patients.

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Food allergy is an important problem in the paediatric population. Food products that are most likely to induce allergic reactions include cow’s milk, wheat, peanuts, hen’s eggs, fish and seafood. Food-allergy-related diseases include, among other things, atopic dermatitis, urticaria and asthma. Anaphylactic shock is the most severe form of allergic reaction. Intramuscular adrenalin at a dose of 0.01 mg/kg body weight (maximum dose 0.3–0.5 mg) is the primary treatment for anaphylaxis. An elimination diet is the treatment of choice in food allergy. If symptoms persist despite dietary intervention, extended diagnosis using skin prick tests and/or specific IgE measurements should be performed. We present a clinical case of a 2.5-year-old boy with erythroderma secondary to atopic dermatitis, who was referred to our Department due to the lack of improvement after outpatient treatment. It was found during hospital stay that the symptoms were caused by potato allergens.