Mia Gebauer Madsen1,2, Rikke Nørregaard3, Johan Palmfeldt4, Lars Henning Olsen5, Jørgen Frøkiær3, Troels Munch Jørgensen5. 1. Department of Urology, Pediatric Section, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark. miagebauermadsen@ki.au.dk. 2. The Water and Salt Research Center, Institute of Clinical Medicine, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark. miagebauermadsen@ki.au.dk. 3. The Water and Salt Research Center, Institute of Clinical Medicine, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark. 4. Research Unit for Molecular Medicine, Aarhus University Hospital, Brendstrupgaardsvej 21, 8200, Aarhus N, Denmark. 5. Department of Urology, Pediatric Section, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark.
Abstract
BACKGROUND: Ureteropelvic junction obstruction (UPJO) accounts for 35 % of all congenital hydronephrosis cases. The challenge in managing childhood hydronephrosis is to distinguish obstructive from nonobstructive cases and, thereby, identify patients requiring surgical intervention. This study aimed to examine four urinary proteins as potential biomarkers of obstruction in hydronephrosis. METHODS: Urine samples from 24 children with UPJO were collected pre-, peri-, and postoperatively, together with urine samples from healthy children. Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CyC), β2-microglobulin (β2-M), and osteopontin (OPN) in the samples were measured simultaneously using multiplex sandwich immunoassay technology. RESULTS: Compared with controls, NGAL and β2-M were significantly increased in urine from patients with obstructed kidneys at the time of surgery. This increase was followed by a decrease and stabilization to the same level as that of the controls. Furthermore, age was negatively correlated with preoperative urinary concentrations of CyC, β2-M, and OPN. CONCLUSIONS: This study confirms increased concentrations of NGAL and β2-M in urine from obstructed kidneys and should be tested in larger studies to ascertain their ability to identify obstruction and to determine the importance of age-adjusted reference values.
BACKGROUND:Ureteropelvic junction obstruction (UPJO) accounts for 35 % of all congenital hydronephrosis cases. The challenge in managing childhood hydronephrosis is to distinguish obstructive from nonobstructive cases and, thereby, identify patients requiring surgical intervention. This study aimed to examine four urinary proteins as potential biomarkers of obstruction in hydronephrosis. METHODS: Urine samples from 24 children with UPJO were collected pre-, peri-, and postoperatively, together with urine samples from healthy children. Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CyC), β2-microglobulin (β2-M), and osteopontin (OPN) in the samples were measured simultaneously using multiplex sandwich immunoassay technology. RESULTS: Compared with controls, NGAL and β2-M were significantly increased in urine from patients with obstructed kidneys at the time of surgery. This increase was followed by a decrease and stabilization to the same level as that of the controls. Furthermore, age was negatively correlated with preoperative urinary concentrations of CyC, β2-M, and OPN. CONCLUSIONS: This study confirms increased concentrations of NGAL and β2-M in urine from obstructed kidneys and should be tested in larger studies to ascertain their ability to identify obstruction and to determine the importance of age-adjusted reference values.
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