a School of Basic Medicine , Henan University of Traditional Chinese Medicine , Zhengzhou , PR China.
b Pathological Experiment Center, Henan University of Traditional Chinese Medicine , Zhengzhou , PR China.
Scand J Clin Lab Invest. 2018 Feb-Apr;78(1-2):55-61. doi: 10.1080/00365513.2017.1411972. Epub 2017 Dec 3.
Congenital obstructive nephropathy is amongst the main causes of chronic renal failure in children. Early diagnosis and initiation of the treatment will delay progressive renal tubular atrophy and interstitial fibrosis with the loss of nephrons. The aim of this study was to evaluate whether urinary (u) semaphorin-3A (SEMA-3A) and Netrin-1 may be potential biomarkers in children with congenital hydronephrosis due to ureteropelvic junction obstruction (UPJO). The study consisted of 42 children with severe hydronephrosis who needed surgery and two control groups (Control One: 42 children with mild, non-obstructive hydronephrosis; Control Two: 44 healthy children). All children had normal renal function. Urinary semaphorin-3A and Netrin-1 levels were measured in different groups using immunoenzymatic ELISA commercial kits. Compared with Control One and Control Two groups, the preoperative median uSEMA-3A/creatinine (cr.) and uNetrin-1/cr. levels increased significantly in the children with severe hydronephrosis (p < .01). One month after surgery, uSEMA-3A/cr. and uNetrin-1/cr. levels had decreased significantly in the children with severe hydronephrosis (p < .01), but were still higher than those in both control groups (p < .05). Receiver operator characteristic (ROC) analyses revealed a good diagnostic profile for uSEMA-3A and uNetrin-1 in terms of identifying children with a differential renal function of <40% [area under the curve (AUC) 0.825 and 0.745, respectively]. Our results indicate that increased concentrations of uSEMA-3A and uNetrin-1 are found in urine from children with severe hydronephrosis and that their concentrations are related to the degree of obstruction.
先天性梗阻性肾病是儿童慢性肾衰竭的主要原因之一。早期诊断和治疗的启动将延迟进行性肾小管萎缩和间质纤维化，导致肾单位丧失。本研究旨在评估尿（u）信号素-3A（SEMA-3A）和 Netrin-1 是否可能成为先天性肾盂积水（UPJO）导致输尿管肾盂连接部梗阻（UPJO）儿童的潜在生物标志物。该研究包括 42 名需要手术的严重肾积水患儿和两个对照组（对照组 1：42 名轻度、非梗阻性肾积水患儿；对照组 2：44 名健康儿童）。所有儿童肾功能正常。使用免疫酶联免疫吸附测定（ELISA）商业试剂盒测量不同组的尿 SEMA-3A 和 Netrin-1 水平。与对照组 1 和对照组 2 相比，严重肾积水患儿术前 uSEMA-3A/肌酐（cr.）和 uNetrin-1/cr. 中位数水平显著升高（p<.01）。严重肾积水患儿手术后 1 个月，uSEMA-3A/cr. 和 uNetrin-1/cr. 水平显著下降（p<.01），但仍高于两个对照组（p<.05）。受试者工作特征（ROC）分析显示，uSEMA-3A 和 uNetrin-1 对鉴别肾功能差异<40%的儿童具有良好的诊断特征 [曲线下面积（AUC）分别为 0.825 和 0.745]。我们的结果表明，严重肾积水患儿尿中 uSEMA-3A 和 uNetrin-1 浓度升高，其浓度与梗阻程度相关。
