Suchiang Biangchwadaka, Pathak Manish, Saxena Rahul, Sharma Shailja, Mittal Aliza, Nayak Shubhalaxmi, Jadhav Avinash, Rathod Kirtikumar, Sinha Arvind
Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, India.
Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India.
Pediatr Surg Int. 2022 Nov;38(11):1635-1641. doi: 10.1007/s00383-022-05207-x. Epub 2022 Sep 4.
The decision to surgically intervene in a hydronephrotic kidney in children is based on many debatable guidelines, some requiring repeated ultrasounds or renal scans. Urinary proteins have the potential to reflect renal disorders and hence can be the alternatives to such scans. Here, we aim to assess the role of urinary Neutrophil Gelatinase-Associated Lipocalin, Monocyte Chemoattractant Protein-1, and Interleukin-6 (IL-6) in such patients.
Seventeen children had obstructive hydronephrosis requiring pyeloplasty (UPJO), while seven were kept on conservative management in view of non-obstructive dilation (NOD). Urine samples were measured for the three urinary proteins at the time of presentation and following pyeloplasty using commercially available ELISA kits.
The levels of all three urinary proteins were significantly higher in patients with UPJO children compared to the NOD group. Cut-off values to differentiate obstructive from non-obstructive hydronephrosis were obtained. A significant fall in the post-operative value of urinary IL-6 was also observed.
This study highlights the potentiality of urinary proteins as biomarkers in identifying children with hydronephrosis and picking out the ones with obstructive hydronephrosis who will require pyeloplasty. The drop in levels after pyeloplasty can be employed to evaluate the effectiveness of pyeloplasty when sent serially.
对儿童肾积水进行手术干预的决策基于许多有争议的指导方针,其中一些要求重复进行超声检查或肾脏扫描。尿蛋白有可能反映肾脏疾病,因此可以作为此类扫描的替代方法。在此,我们旨在评估尿中性粒细胞明胶酶相关脂质运载蛋白、单核细胞趋化蛋白-1和白细胞介素-6(IL-6)在此类患者中的作用。
17名患有梗阻性肾积水需要肾盂成形术(UPJO)的儿童,而7名因非梗阻性扩张(NOD)接受保守治疗。在就诊时和肾盂成形术后,使用市售ELISA试剂盒检测尿样中的三种尿蛋白。
与NOD组相比,UPJO儿童患者的所有三种尿蛋白水平均显著更高。获得了区分梗阻性和非梗阻性肾积水的临界值。术后尿IL-6值也显著下降。
本研究强调了尿蛋白作为生物标志物在识别肾积水儿童以及挑选出需要肾盂成形术的梗阻性肾积水儿童方面的潜力。肾盂成形术后水平的下降可在连续送检时用于评估肾盂成形术的有效性。