Pediatric Nephrology

, Volume 25, Issue 9, pp 1673–1678

Urinary proteome analysis identifies infants but not older children requiring pyeloplasty

  • Jens Drube
  • Petra Zürbig
  • Eric Schiffer
  • Esther Lau
  • Benno Ure
  • Sylvia Glüer
  • Martin Kirschstein
  • Lars Pape
  • Stéphane Decramer
  • Jean-Loup Bascands
  • Joost P. Schanstra
  • Harald Mischak
  • Jochen H. H. Ehrich
Original Article

DOI: 10.1007/s00467-010-1455-8

Cite this article as:
Drube, J., Zürbig, P., Schiffer, E. et al. Pediatr Nephrol (2010) 25: 1673. doi:10.1007/s00467-010-1455-8

Abstract

One out of every five children suffering from ureteropelvic junction obstruction (UPJO) requires pyeloplasty. This prevalence indicates an urgent necessity to identify high-grade UPJO as early as possible to avoid renal damage. A novel non-invasive proteomic urine test has recently been introduced that is able to detect these patients at an early stage. In the study reported here, we tested this approach to assess its use in our centre and to expand its application to older children. Twenty-seven children (median age 0.4 years, range 0.1–8.8 years) with hydronephrosis who had been scheduled a nuclear diuretic renal scan (DR) to identify urodynamically relevant UPJO were included in our prospective study. Patients with prior surgery of the urinary tract were excluded. The urinary proteome pattern was analysed using capillary electrophoresis coupled to mass spectrometry. Of the 27 children, 11 had a relevant UPJO diagnosed by the DR. In 19 children <1 year of age, urinary proteome analysis predicted obstruction with a sensitivity of 83% (5/6) and a specificity of 92% (12/13). However, in older patients, the sensitivity decreased to 20% (1/5) and specificity to 66% (2/3). Based on our results, the proteome pattern established by Decramer and co-workers predicts the need for surgery in infants but not in older children with UPJO.

Keywords

Capillary electrophoresisDiagnosticsMass spectrometryProteomicsSurgeryUreteropelvic junction obstruction

Copyright information

© IPNA 2010

Authors and Affiliations

  • Jens Drube
    • 1
    • 8
  • Petra Zürbig
    • 2
  • Eric Schiffer
    • 2
  • Esther Lau
    • 3
  • Benno Ure
    • 3
    • 4
  • Sylvia Glüer
    • 4
  • Martin Kirschstein
    • 5
  • Lars Pape
    • 1
  • Stéphane Decramer
    • 6
    • 7
  • Jean-Loup Bascands
    • 6
    • 7
  • Joost P. Schanstra
    • 6
    • 7
  • Harald Mischak
    • 2
  • Jochen H. H. Ehrich
    • 1
  1. 1.Department of Pediatric Kidney, Liver and Metabolic Diseases, Children’s HospitalHannover Medical SchoolHannoverGermany
  2. 2.Mosaiques Diagnostics GmbHHannoverGermany
  3. 3.Center of Pediatric Surgery HannoverHannoverGermany
  4. 4.Center of Pediatric Surgery HannoverHannover Medical SchoolHannoverGermany
  5. 5.Pediatric DepartmentCelle General Hospital, Teaching Hospital of Hannover Medical SchoolCelleGermany
  6. 6.U858Institut National de la Santé et de la Recherche Médicale (INSERM)ToulouseFrance
  7. 7.Equipe no. 5, IFR150, Institut de Médecine Moléculaire de RangueilUniversité Toulouse III Paul-SabatierToulouseFrance
  8. 8.Department of Pediatric Nephrology, Children’s HospitalHannover Medical SchoolHannoverGermany