Abstract
BackgroundWe aimed to evaluate possible clinical application of urinary monocyte chemotactic protein-1 (MCP-1), osteopontin (OPN), and regulated upon activation, normal T-cell expressed and secreted (RANTES) chemokine as useful noninvasive markers in children with congenital hydronephrosis (HN) caused by ureteropelvic junction obstruction (UPJO).MethodsThe study cohort consisted of surgical cases (study group 1), comprising 15 children with severe HN who required surgery (median age 1.03 years), conservative cases (study group 2), comprising 21 patients with mild, nonobstructive HN, and control group, comprising 19 healthy children. All children had normal renal function. Urinary (u) concentrations of MCP-1, OPN, and RANTES were measured using immunoenzymatic enzyme-linked immunosorbent assay (ELISA) commercial kits and were expressed in nanograms per milligram creatinine. Increased levels of MCP-1 and OPN were found in children with HN in comparison with study group 2 and controls (p < 0.05). UMCP-1/Cr correlated with half-time (T1/2) of the elimination phase of tracer excretion of technetium-99m-mercaptoacetyltriglycine (99mTc-MAG-3) (p < 0.05).ResultsReceiver operator characteristic (ROC) analyses revealed good diagnostic profile for uMCP-1 only in identifying children (<40 %) with abnormal differential renal function (DRF) [area under the curve (AUC) 0.862], and in detecting kidney injury in all examined children (AUC 0.704).ConclusionsAdditional studies with larger number of patients are required to confirm a potential application of uMCP-1 as a promising parameter for early identification of kidney obstruction.
Highlights
Hydronephrosis (HN) is defined as distension to varying degrees of pelvis and calyces accompanied by progressive atrophy of renal parenchyma due to obstruction in urinary flow [1]
The criterion adopted for inclusion in study group 1 was differential renal function (DRF) 40 mm and half-time (T1/2) of the elimination phase of technetium-99mmercaptoacetyltriglycine (99mTc-MAG-3) diuretic renogram>20 min
We found that increase in T1/2 tracer excretion >20 min was associated with increase in monocyte chemotactic protein-1 (MCP-1) [odds ratio (OR) 3.8; confidence interval (CI) 0.84– 17.0] and RANTES but not in OPN
Summary
Hydronephrosis (HN) is defined as distension to varying degrees of pelvis and calyces accompanied by progressive atrophy of renal parenchyma due to obstruction in urinary flow [1]. There is a need for improved methods to evaluate patients with congenital obstructive nephropathy, to time intervention, and to track progression and Pediatr Nephrol (2012) 27:2107–2113 response to therapy. Whereas the ultimate goal is to find new therapies to minimize progression of renal injury, the interests of clinicians have focused on the potential role of plasma or urine markers, such as monocyte chemotactic protein-1 (MCP-1), osteopontin (OPN), and regulated upon activation normal T-cell expressed and secreted (RANTES) chemokine. We aimed to evaluate possible clinical application of urinary monocyte chemotactic protein-1 (MCP-1), osteopontin (OPN), and regulated upon activation, normal T-cell expressed and secreted (RANTES) chemokine as useful noninvasive markers in children with congenital hydronephrosis (HN) caused by ureteropelvic junction obstruction (UPJO). Results Receiver operator characteristic (ROC) analyses revealed good diagnostic profile for uMCP-1 only in identifying children (
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