2024, Number 5
<< Back Next >>
Rev Mex Pediatr 2024; 91 (5)
Comparison of urinary biomarkers in children with obstruction or dilation of the upper urinary tract
Godínez-Álvarez P, Ramírez-Velázquez E, Díaz-Pardo M, González-Ledón FJ, Medeiros-Domingo M, Zurita-Cruz JN
Language: Spanish
References: 17
Page: 175-180
PDF size: 416.18 Kb.
ABSTRACT
Introduction: non-obstructive urinary tract dilation is usually transient; however, there is a risk of developing ureteropelvic stricture (UPS).
Objective: to compare urinary levels of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin C between patients with urinary tract obstruction (UTO) or non-obstructive upper urinary tract dilation (UTD).
Material and methods: a cross-sectional study was conducted with patients aged < 18 years with OTU and DTU secondary to UPS. Statistical analysis: the Mann-Whitney U test was used to compare urinary biomarker levels between the two study groups.
Results: twenty-two patients were studied (18 with OTU and 4 with DTU); the majority were male (n = 16). The median age was 4.7 months. NGAL values ??in the OTU group had a median of 103.75 ng/mgCr, which was significantly higher than those in the DTU group (16.71 ng/mgCr), p = 0.049. The median KIM-1 values ??were 2.11 ng/mgCr and 2.29 ng/mgCr, respectively (p = 0.829). Finally, for cystatin C the medians were 12.34 ng/mgCr and 6.40 ng/mgCr, but with no statistical difference (p = 0.307).
Conclusions: in patients with UPS, NGAL appears to be a useful biomarker to differentiate patients with obstruction from those with non-obstructive dilation.
REFERENCES
Nguyen HT, Herndon CD, Cooper C, Gatti J, Kirsch A, Kokorowski P et al. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol. 2010; 6(3): 212-231. doi: 10.1016/j.jpurol.2010.02.205.
Balster S, Schiborr M, Brinkmann OA, Hertle L. Obstruktive Uropathien im Kindesalter [Obstructive uropathy in childhood]. Aktuelle Urol. 2005; 36(4): 317-328. doi: 10.1055/s-2005-870934.
Grapin C, Auber F, de Vries P, Audry G, Helardot P. Postnatal management of urinary tract anomalies after antenatal diagnosis. J Gynecol Obstet Biol Reprod (Paris). 2003; 32(4): 300-313.
Sharma GR, Panda A, Sharma AG. Renal cortical transit time in the evaluation of prenatally detected presumed pelvi ureteric junction like obstruction: a systematic review. Indian J Urol. 2021; 37(2): 116-124. doi: 10.4103/iju.IJU_236_20.
Farrugia MK, Hitchcock R, Radford A, Burki T, Robb A, Murphy F; British Association of Paediatric Urologists. British Association of Paediatric Urologists consensus statement on the management of the primary obstructive megaureter. J Pediatr Urol. 2014; 10(1): 26-33. doi: 10.1016/j.jpurol.2013.09.018.
Norregaard R, Mutsaers HAM, Frokiaer J, Kwon TH. Obstructive nephropathy and molecular pathophysiology of renal interstitial fibrosis. Physiol Rev. 2023; 103(4): 2827-2872. doi: 10.1152/physrev.00027.2022.
Wasilewska A, Taranta-Janusz K, Debek W, Zoch-Zwierz W, Kuroczycka-Saniutycz E. KIM-1 and NGAL: new markers of obstructive nephropathy. Pediatr Nephrol. 2011; 26(4): 579-586. doi: 10.1007/s00467-011-1773-5.
Cost NG, Noh PH, Devarajan P, Ivancic V, Reddy PP, Minevich E et al. Urinary NGAL levels correlate with differential renal function in patients with ureteropelvic junction obstruction undergoing pyeloplasty. J Urol. 2013; 190(4 Suppl): 1462-1467. doi: 10.1016/j.juro.2013.05.003.
Lucarelli G, Mancini V, Galleggiante V, Rutigliano M, Vavallo A, Battaglia M et al. Emerging urinary markers of renal injury in obstructive nephropathy. Biomed Res Int. 2014; 2014: 303298. doi: 10.1155/2014/303298.
Noyan A, Parmaksiz G, Dursun H, Ezer SS, Anarat R, Cengiz N. Urinary NGAL, KIM-1 and L-FABP concentrations in antenatal hydronephrosis. J Pediatr Urol. 2015; 11(5): 249.e1-6. doi: 10.1016/j.jpurol.2015.02.021.
Karakus S, Oktar T, Kucukgergin C, Kalelioglu I, Seckin S, Atar A et al. Urinary IP-10, MCP-1, NGAL, cystatin-C, and KIM-1 levels in prenatally diagnosed unilateral hydronephrosis: the search for an ideal biomarker. Urology. 2016; 87: 185-192. doi: 10.1016/j.urology.2015.09.007.
Bienias B, Sikora P. Potential novel biomarkers of obstructive nephropathy in children with hydronephrosis. Dis Markers. 2018; 2018: 1015726. doi: 10.1155/2018/1015726.
Gupta S, Jackson AR, DaJusta DG, McLeod DJ, Alpert SA, Jayanthi VR et al. Urinary antimicrobial peptides: Potential novel biomarkers of obstructive uropathy. J Pediatr Urol. 2018; 14(3): 238.e1-238.e6. doi: 10.1016/j.jpurol.2018.03.006.
Kostic D, Dos Santos Beozzo GPN, do Couto SB, Kato AHT, Lima L, Palmeira P et al. First-year profile of biomarkers for early detection of renal injury in infants with congenital urinary tract obstruction. Pediatr Nephrol. 2019; 34(6): 1117-1128. doi: 10.1007/s00467-019-4195-4.
Pavlaki A, Printza N, Farmaki E, Stabouli S, Taparkou A, Sterpi M et al. The role of urinary NGAL and serum cystatin C in assessing the severity of ureteropelvic junction obstruction in infants. Pediatr Nephrol. 2020; 35(1): 163-170. doi: 10.1007/s00467-019-04349-w.
Ozkuvanc? U, Donmez MI, Ziylan O, Oktar T, Kucukgergin C, Cetin B et al. Can urinary biomarkers detect obstruction defined by renal functional loss in antenatal hydronephrosis? J Pediatr Urol. 2020; 16(6): 844.e1-844.e7. doi: 10.1016/j.jpurol.2020.09.005.
Chevalier RL, Peters CA. Congenital urinary tract obstruction: proceedings of the State-Of-The-Art Strategic Planning Workshop-National Institutes of Health, Bethesda, Maryland, USA, 11-12 March 2002. Pediatr Nephrol. 2003; 18(6): 576-606. doi: 10.1007/s00467-003-1074-8.