Abstract
Background: Fetal hydronephrosis (HN) is a prevalent condition detected in prenatal ultrasounds, affecting 1-5% of pregnancies. While mild cases often resolve without intervention, severe cases frequently require surgical treatment. Objectives: This study investigates the association between L-arginine levels and the severity of neonatal HN, as prior research has indicated L-arginine’s crucial role in kidney function. Methods: A prospective case-control study was conducted at the Children's Medical Center in Tehran from October 2021 to October 2023. Neonates with HN (n = 24) were compared with healthy control neonates (n = 24). Arginine levels in plasma and urine were measured using LC-MS/MS. Statistical analyses included Pearson correlation coefficients and receiver operating characteristic (ROC) curves to assess the need for surgical intervention. Results: Urine arginine levels were significantly lower in the HN group compared to the controls (P = 0.03), while plasma arginine levels showed no significant difference (P = 0.82). A significant positive correlation was found between urine arginine levels in the HN and control groups [r (24) = 0.44, P < 0.05], but no significant correlations with kidney measurements or clinical outcomes were observed. Thirteen patients (54.2%) required surgery, with ROC analysis indicating low sensitivity (AUC = 0.53, P = 0.7). Conclusions: Our findings suggest that urine arginine levels may be lower in neonates with HN, indicating a potential link between arginine and kidney function. However, further research is needed to validate these findings and explore the utility of arginine as a cost-effective biomarker for the early detection of kidney abnormalities in pediatric nephrology.
Published Version
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