PD40-04 DIAGNOSTIC ACCURACY OF URINARY β2-MICROGLOBULIN, CA19-9, NGAL AND KIM-1 IN URETEROPELVIC JUNCTION OBSTRUCTION IN ADULTS

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion III1 Apr 2016PD40-04 DIAGNOSTIC ACCURACY OF URINARY β2-MICROGLOBULIN, CA19-9, NGAL AND KIM-1 IN URETEROPELVIC JUNCTION OBSTRUCTION IN ADULTS Eduardo Miranda, José de Bessa Jr., Roberto Lopes, Victor Sougi, Hiury Andrade, Rodolfo Bandeira, Marco Arap, Anuar Mittre, Nayara Viana, Sabrina dos Reis, Katia Leite, Miguel Sougi, and Ricardo Duarte Eduardo MirandaEduardo Miranda More articles by this author , José de Bessa Jr.José de Bessa Jr. More articles by this author , Roberto LopesRoberto Lopes More articles by this author , Victor SougiVictor Sougi More articles by this author , Hiury AndradeHiury Andrade More articles by this author , Rodolfo BandeiraRodolfo Bandeira More articles by this author , Marco ArapMarco Arap More articles by this author , Anuar MittreAnuar Mittre More articles by this author , Nayara VianaNayara Viana More articles by this author , Sabrina dos ReisSabrina dos Reis More articles by this author , Katia LeiteKatia Leite More articles by this author , Miguel SougiMiguel Sougi More articles by this author , and Ricardo DuarteRicardo Duarte More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1536AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteropelvic junction obstruction (UPJO) causes urinary tract obstruction and can lead to progressive deterioration of renal function. In this context the development of novel methods capable of discriminating obstruction and hydronephrosis may be useful. The aim of this study was to evaluate the diagnostic accuracy properties of four urinary biomarkers in adults with UPJO: β2-microglobulin (β2M), CA19-9, NGAL and KIM-1. It was also our goal to assess the behavior of these urinary biomarkers following pyeloplasty. METHODS We prospectively studied patients aged >18 years diagnosed with UPJO undergoing laparoscopic pyeloplasty from December 2013 to February 2015. We excluded patients with bilateral UPJO, unilateral UPJO and contralateral pathologic kidney, solitary kidney, history of previous treatment for UPJO, and renal insufficiency. Each patient provided four samples of voided urine for biomarker measurement, one at preoperative consultation and the others at 1, 3 and 6 months of postoperative follow-up. A control group was selected among healthy individuals with no hydronephrosis on ultrasound evaluation. RESULTS We included 47 patients with a mean age of 38.6 ± 12.7 years (range 19-64 years), from which 17 (36.2%) were males and 30 (62.8%) were females. The control group consisted of 44 subjects aged 38.3 ± 13.0 years, 14 (31.8%) men and 30 (68.2%) women. The groups were similar regarding age (p = 0.95) and gender (p = 0.82). β2M had an area under the curve (AUC) of 0.61 (95% CI 0.50-0.73) and was the only biomarker with inadequate properties in this scenario. CA19-9 had an AUC of 0.70 (95% CI 0.60-0.81), NGAL 0.71 (95% CI 0.61-0.83) and KIM-1 0.79 (95% CI 0.70-0.89). These 3 biomarkers showed similar diagnostic properties, in which KIM-1 was the most sensitive marker with a cutoff of 170.0 pg/mg creatinine (sensitivity 91.4%, specificity 59.1%) and CA 19-9 as the most specific one, displaying a cutoff of 50.0 U/mg creatinine (sensitivity 48.9%, specificity 88.0%). After pyeloplasty, there was a significant decrease in biomarkers concentrations, reaching levels similar to controls. CONCLUSIONS The evaluation of urinary biomarkers is useful in the assessment of UPJO in adults undergoing laparoscopic pyeloplasty. Urinary concentrations of CA 19-9, NGAL and KIM-1 were elevated in patients with UPJO and significantly decreased after pyeloplasty. The exact role of those biomarkers in the setting of obstruction in adults should be further evaluated. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e936-e937 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Eduardo Miranda More articles by this author José de Bessa Jr. More articles by this author Roberto Lopes More articles by this author Victor Sougi More articles by this author Hiury Andrade More articles by this author Rodolfo Bandeira More articles by this author Marco Arap More articles by this author Anuar Mittre More articles by this author Nayara Viana More articles by this author Sabrina dos Reis More articles by this author Katia Leite More articles by this author Miguel Sougi More articles by this author Ricardo Duarte More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...