ESPN 51th Annual Meeting

ESPN 2018


 
EARLY INDICATORS OF RENAL DYSFUNCTION IN NEONATES AND INFANTS WITH URETEROPELVIC JUNCTION OBSTRUCTION
ANTIGONI PAVLAKI 1 NIKOLETA PRINTZA 1 EVANGELIA FARMAKI 1 STELLA STABOULI 1 JOHN DOTIS 1 ANNA TAPARKOU 1 OLGA BEGOU 2 CHRYSA GKOGKA 1 FOTIOS PAPACHRISTOU 1

1- PEDIATRIC NEPHROLOGY UNIT, FIRST DEPARTMENT OF PEDIATRICS, HIPPOKRATION HOSPITAL, ARISTOTLE UNIVERSITY OF THESSALONIKI
2- LABORATORY OF ANALYTICAL CHEMISTRY, DEPARTMENT OF CHEMISTRY, ARISTOTLE UNIVERSITY OF THESSALONIKI
 
Introduction:

Evaluation of newer biomarkers of renal dysfunction in infants and children with ureteropelvic junction obstruction (UPJO) attempting to clarify: a) their precision to segregate surgical cases from non-surgical and b) their ability to detect earlier the impairment of renal function.

Material and methods:

Serum and urine samples were collected from the following groups of children: a) 22 patients with surgical UPJO, planned to undergo surgery. Samples were collected at initial diagnosis and 12 months postoperatively (groups A1 and A2 respectively) b) 19 cases of nonsurgical UPJO (group B) and c) 22 healthy infants were recruited as controls (group C). All participants had normal creatinine values. Serum levels of Cystatin C and urinary levels of NGAL were measured using immunoenzymatic ELISA commercial kits. 

Results:

Urinary NGAL was significantly higher in group A1 in comparison to group A2 (p=0.02) as well as to group C (p=0.03), while there was not a statistically significant difference between groups A2 and C (p=0.77). Likewise Cystatin C levels were significantly higher in group A1 vs group A2 (p=0.004) and in group A1 vs group C (p=0.02), but no difference was observed between groups A2 and C (p=0.82). Urinary NGAL and serum Cystatin C did not differ between groups B and A, nor between groups B and C. 

Conclusions:

NGAL and Cystatin C were able to separate surgical cases from healthy controls and their levels appear to improve significantly after appropriate surgical intervention. However they have failed to separate surgical UPJO from nonsurgical. Their usefulness as biomarkers in UPJO remains to be elucidated in larger studies, combined with other biomolecules or different methods.