Integral kidney function assessment in pediatric patients with glycogen storage diseases

IntroductionGlycogen storage diseases (GSDs) are a group of hereditary metabolic disorders with variable clinical manifestations, depending on the enzyme and organ affected. Renal dysfunction, including hyperfiltration, proteinuria, and renal tubular acidosis (RTA), is a known complication, particul...

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Main Authors: Magali Reyes-Apodaca, Alejandra Consuelo-Sánchez, Rodrigo Vázquez-Frias, Benjamín Antonio Rodríguez-Espino, Mara Medeiros
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1543164/full
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author Magali Reyes-Apodaca
Magali Reyes-Apodaca
Alejandra Consuelo-Sánchez
Rodrigo Vázquez-Frias
Rodrigo Vázquez-Frias
Benjamín Antonio Rodríguez-Espino
Mara Medeiros
Mara Medeiros
author_facet Magali Reyes-Apodaca
Magali Reyes-Apodaca
Alejandra Consuelo-Sánchez
Rodrigo Vázquez-Frias
Rodrigo Vázquez-Frias
Benjamín Antonio Rodríguez-Espino
Mara Medeiros
Mara Medeiros
author_sort Magali Reyes-Apodaca
collection DOAJ
description IntroductionGlycogen storage diseases (GSDs) are a group of hereditary metabolic disorders with variable clinical manifestations, depending on the enzyme and organ affected. Renal dysfunction, including hyperfiltration, proteinuria, and renal tubular acidosis (RTA), is a known complication, particularly in GSD types of Ia and Ib.MethodsThis cross-sectional study evaluated renal function in 17 pediatric patients with different GSD types using an integral kidney assessment (IKA). The comprehensive evaluation included biochemical and urinary analyses, glomerular filtration rate calculations, and acidification tests.ResultsThe median age at first renal evaluation was 33 months, and nutritional management was often suboptimal at this stage. Through IKA, renal alterations were identified in 47% of the patients. Hyperfiltration was present in 40% of GSD type I patients, while lactic acidosis was noted in 30% of these cases. Two siblings with GSD XI presented with proximal RTA and Fanconi syndrome, highlighting severe tubular involvement. Distal RTA was documented in one non-adherent GSD Ia patient, underscoring the importance of metabolic control.DiscussionThis study emphasizes the heterogeneity of renal manifestations among different GSD subtypes. Hyperfiltration, particularly in GSD I, may result from altered energy metabolism and compensatory mechanisms within the renal tubules. Proximal tubular damage in GSD XI reflects glycogen and monosaccharide accumulation within renal epithelial cells. Adherence to dietary and medical interventions is critical for mitigating renal complications and ensuring growth and development in GSD patients. Annual kidney evaluations are recommended for early detection of renal dysfunction, enabling timely initiation of therapeutic strategies such as alkali therapy and angiotensin-converting enzyme inhibitors.
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spelling doaj-art-b10e6d7a852744159a024d8b247b735e2025-08-20T02:29:02ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-04-011310.3389/fped.2025.15431641543164Integral kidney function assessment in pediatric patients with glycogen storage diseasesMagali Reyes-Apodaca0Magali Reyes-Apodaca1Alejandra Consuelo-Sánchez2Rodrigo Vázquez-Frias3Rodrigo Vázquez-Frias4Benjamín Antonio Rodríguez-Espino5Mara Medeiros6Mara Medeiros7Faculty of Medicine, National Autonomous University of Mexico, Mexico City, MexicoNephrology and Bone Mineral Metabolism Research and Diagnostic Unit, Hospital Infantil de México Federico Gómez, Mexico City, MexicoDepartment of Gastroenterology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, MexicoDepartment of Gastroenterology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, MexicoResearch Management Assistant Office, Hospital Infantil de México Federico Gómez, Mexico City, MexicoNephrology and Bone Mineral Metabolism Research and Diagnostic Unit, Hospital Infantil de México Federico Gómez, Mexico City, MexicoResearch Direction Office, Hospital Infantil de México Federico Gómez, Mexico City, MexicoPharmacology Department, National Autonomous University of Mexico, Mexico City, MexicoIntroductionGlycogen storage diseases (GSDs) are a group of hereditary metabolic disorders with variable clinical manifestations, depending on the enzyme and organ affected. Renal dysfunction, including hyperfiltration, proteinuria, and renal tubular acidosis (RTA), is a known complication, particularly in GSD types of Ia and Ib.MethodsThis cross-sectional study evaluated renal function in 17 pediatric patients with different GSD types using an integral kidney assessment (IKA). The comprehensive evaluation included biochemical and urinary analyses, glomerular filtration rate calculations, and acidification tests.ResultsThe median age at first renal evaluation was 33 months, and nutritional management was often suboptimal at this stage. Through IKA, renal alterations were identified in 47% of the patients. Hyperfiltration was present in 40% of GSD type I patients, while lactic acidosis was noted in 30% of these cases. Two siblings with GSD XI presented with proximal RTA and Fanconi syndrome, highlighting severe tubular involvement. Distal RTA was documented in one non-adherent GSD Ia patient, underscoring the importance of metabolic control.DiscussionThis study emphasizes the heterogeneity of renal manifestations among different GSD subtypes. Hyperfiltration, particularly in GSD I, may result from altered energy metabolism and compensatory mechanisms within the renal tubules. Proximal tubular damage in GSD XI reflects glycogen and monosaccharide accumulation within renal epithelial cells. Adherence to dietary and medical interventions is critical for mitigating renal complications and ensuring growth and development in GSD patients. Annual kidney evaluations are recommended for early detection of renal dysfunction, enabling timely initiation of therapeutic strategies such as alkali therapy and angiotensin-converting enzyme inhibitors.https://www.frontiersin.org/articles/10.3389/fped.2025.1543164/fullglycogen storage diseasesrenal dysfunctionhyperfiltrationrenal tubular acidosispediatric nephrologymetabolic disorders
spellingShingle Magali Reyes-Apodaca
Magali Reyes-Apodaca
Alejandra Consuelo-Sánchez
Rodrigo Vázquez-Frias
Rodrigo Vázquez-Frias
Benjamín Antonio Rodríguez-Espino
Mara Medeiros
Mara Medeiros
Integral kidney function assessment in pediatric patients with glycogen storage diseases
Frontiers in Pediatrics
glycogen storage diseases
renal dysfunction
hyperfiltration
renal tubular acidosis
pediatric nephrology
metabolic disorders
title Integral kidney function assessment in pediatric patients with glycogen storage diseases
title_full Integral kidney function assessment in pediatric patients with glycogen storage diseases
title_fullStr Integral kidney function assessment in pediatric patients with glycogen storage diseases
title_full_unstemmed Integral kidney function assessment in pediatric patients with glycogen storage diseases
title_short Integral kidney function assessment in pediatric patients with glycogen storage diseases
title_sort integral kidney function assessment in pediatric patients with glycogen storage diseases
topic glycogen storage diseases
renal dysfunction
hyperfiltration
renal tubular acidosis
pediatric nephrology
metabolic disorders
url https://www.frontiersin.org/articles/10.3389/fped.2025.1543164/full
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