Comparing predictive values of carbohydrate antigen 19-9, neutrophil gelatinase–associated lipocalin, and kidney injury molecule-1 in 161 patients with ureteropelvic junction obstruction

Fendereski, Kiarad; Nabighadim, Amirreza; Seyedtabib, Maryam; Daryabari, Seyedeh Sima; Haghi-Ashtiani, Mohammad Taghi; Kajbafzadeh, Abdol‐Mohammad

doi:10.1007/s00467-020-04750-w

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…However, small sample size and different patterns of obstruction in the compared subgroups were the drawbacks frequently. A prospective study with a significantly larger sample size of 161 patients and a difference in the median age between subgroups of more than 20 months at the time of inclusion (similar to our cohort) demonstrated that the uNGAL level was not while CA19-9 was a significant predictor of surgery ( 25 ). Another 2 pediatric studies with the median age of patients 42 months at inclusion demonstrated no significant differences of bladder uNGAL and KIM-1 between obstructed patients before surgery and healthy controls while a significant elevation of IP-10 and MCP-1 in the pyeloplasty group was present ( 26 , 27 ).…”

Section: Discussionsupporting

confidence: 50%

Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

et al. 2022

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Introduction: To establish the efficacy of ultrasound (US) combined with urine biomarkers in differentiating patients who require surgical management from those who do not, avoiding invasive investigations.Materials and Methods: From February 2019 to February 2021, all pediatric patients who presented with hydronephrosis were selected for the study. All renal units (RU) were evaluated by US, and fresh frozen voided urine samples were collected at the time of inclusion. Hydronephrosis grade was evaluated by the Society for Fetal Urology (SFU) and an alternative grading system (AGS). Patients who had high-grade hydronephrosis on US were referred to renal scan (RS) or intervention, when there was an increase of dilatation in subsequent follow-up images. Fresh frozen urine from the control group with no history of renal diseases and no renal anomalies on US was collected. We compared differences of US parameters combined with urine biomarkers between surgically and non-surgically managed patients and between the groups of patients when they were stratified by different RS findings and analyzed whether urinary biomarkers give any additional value to US. Instead of the anterior–posterior diameter (APD), we used its ratio with mid-parenchymal thickness. The additional efficacy of biomarkers to US was calculated when the US component was derived to a cumulative APD/mid-parenchymal ratio.Results: Sixty-four patients with hydronephrosis were prospectively included in the study accounting for a total of 81 patient visits and 162 RUs evaluated. A control group of 26 patients was collected. The mean age at inclusion in the hydronephrosis group was 43.7(±45.5) months, and a mean age in a control group was 61.2(±41.3) months. The cumulative APD/mid-parenchymal ratio combined with urinary albumin, β2 microglobulin (β2-M), and urinary neutrophil gelatinase-associated lipocalcin may have a better performance in the prediction of surgical intervention than the cumulative APD/mid-parenchymal ratio alone (p = 0.1). The best performance to detect the increased tissue transit time and obstructive curve on RS was demonstrated by the β2-M creatinine ratio. An increased cumulative APD/mid-parenchymal ratio with biomarkers together had a fairly good sensitivity and specificity for detection of DRF < 40%.Conclusions: According to our data, the APD/mid-parenchymal ratio alone has good efficacy in prediction of surgery and abnormal RS findings especially when combined with urine biomarkers.

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Section: Discussionsupporting

confidence: 50%

Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

et al. 2022

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“…In eight studies [6][7][8][9][10][11][12][13] , preoperative NGAL values differed significantly in patients with evidence of UPJ obstruction from healthy children, and in two studies 10,12 in the group of upper tract dilation without obstruction. Fendereski et al 14 reported a significant correlation between renal impairment, urinary NGAL, and CA 19-9.…”

Section: Ngalmentioning

confidence: 99%

“…These authors as well as Kajbafzadeha et al 22 found these values in the group operated on, decreased significantly three months after the operation. According to the most recent study by Fendereski et al 14 , who studied a cohort of 161 patients and had a total follow-up of 2 years, CA 19-9 appears to be a promising predictor of the need for surgery compared to other biomarkers studied (NGAL and KIM 1). This was a well-designed clinical trial, in which the participants were equally divided into two groups (surgery vs. conservative management) and there were no differences in age and sex between the groups.…”

Section: Ca 19-9mentioning

confidence: 99%

The use of biomarkers in the diagnosis and treatment of obstruction of the upper urinary tract in children

Seifriedová

Flögelová

Šarapatka

et al. 2022

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Antenatal hydronephrosis, dilatation of the upper urinary tract (UUTD), is a common finding on prenatal ultrasound. One of the most common causes is ureteropelvic junction (UPJ) obstruction. Although such prenatally diagnosed UUTD resolves spontaneously in most newborns, further examination of these children is advocated to prevent possible irreversible kidney damage, and ultrasound is mainly used for this. If the dilatation persists or becomes symptomatic, it is necessary to proceed to other relatively demanding and invasive diagnostic examinations for these small patients, where the question of the right timing of indications for possible surgical solutions is still unclear. For this reason, various biomarkers have been investigated in a number of clinical trials as potential mini-invasive diagnostic tools for determining when upper urinary tract dilatation in such children poses a threat to the developing kidneys and they should be operated on, and vice versa, when to proceed conservatively. The aim of this article is to review the findings on and current issues with the use of biomarkers in the diagnosis and treatment of UPJ obstruction in children.

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What the Editors are reading – Fetal urology

Wang¹,

Braga²

2020

Journal of Pediatric Urology

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Comparing predictive values of carbohydrate antigen 19-9, neutrophil gelatinase–associated lipocalin, and kidney injury molecule-1 in 161 patients with ureteropelvic junction obstruction

Cited by 4 publications

References 23 publications

Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

The use of biomarkers in the diagnosis and treatment of obstruction of the upper urinary tract in children

What the Editors are reading – Fetal urology

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