Urinary biomarkers in prenatally diagnosed unilateral hydronephrosis

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• 作者：Mia Gebauer Madsen^a ; ^b ; ^{miagebauermadsen@ki.au.dk} ; Rikke Nø ; rregaard^b ; ^{rikke.norregaard@ki.au.dk} ; Jø ; rgen Frø ; kiæ ; r^b ; ^jf@ki.au.dk ; Troels Munch Jø ; rgensen^a ; ^{tmj@dadlnet.dk}
• 关键词：Congenital hydronephrosis ; Ureteropelvic junction obstruction ; Biomarker ; Transforming growth factor beta 1 ; N-Acetyl-beta-d-glucosaminidase ; Alkaline phosphatase ; Gamma-glutamyl transferase ; Monocyte chemotactic peptide-1 ; Epidermal growth factor ; Endoth
• 刊名：Journal of Pediatric Urology
• 出版年：2011
• 出版时间：April 2011
• 年：2011
• 卷：7
• 期：2
• 页码：105-112
• 全文大小：153 K

文摘

The introduction of prenatal ultrasonography as a screening method entails an increasing number of infants diagnosed with prenatal hydronephrosis. Ureteropelvic junction obstruction accounts for 35 % of prenatal hydronephrotic cases. Urinary tract obstruction that occurs during early kidney development affects renal morphogenesis, maturation and growth, and in the most severe cases this will ultimately cause renal insufficiency. A major challenge in the clinical management of these patients is to preserve renal function by selection of the 15 % –20 % who require early surgical intervention, leaving those for whom watchful waiting may be appropriate because of spontaneous resolution/stabilization without significant loss of renal function. Today, this requires medical surveillance, including repetitive invasive diuretic renograms relying on arbitrary threshold values, and therefore there is a need for non-arbitrary, non-invasive urinary biomarkers that may be used as predictors for renal structural changes and/or decreasing renal function, and thereby provide the surgeon with more clear indications for surgical intervention. In this review, we summarize the currently well-known facts about urinary biomarkers in ureteropelvic junction obstruction concerning renal function, and we also suggest potential novel urinary biomarkers.