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Role of urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL), Monocyte Chemoattractant Protein-1(MCP-1), and Interleukin-6(IL-6) as biomarkers in pediatric patients with hydronephrosis

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Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusion

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.

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Abbreviations

USG:

Ultrasonography

99mTc-DTPA:

Diethylenetriaminepentaacetic acid diuretic renography

NGAL:

Neutrophil Gelatinase-Associated Lipocalin

MCP-1:

Monocyte Chemoattractant Protein-1

IL-6:

Interleukin-6

AKI:

Acute kidney injury

ESRD:

End stage renal disease

PUV:

Posterior urethral valve

VUR:

Vesico-ureteral reflux

UPJO:

Ureteropelvic junction obstruction

UTI:

Urinary tract infection

APD:

Anterior–posterior diameter

NOD:

Non-obstructive dilation

DRF:

Differential renal function

IQR:

Interquartile range

AUC:

Area under the curve

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Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, India

    Biangchwadaka Suchiang, Manish Pathak, Rahul Saxena, Shubhalaxmi Nayak, Avinash Jadhav, Kirtikumar Rathod & Arvind Sinha

  2. Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India

    Shailja Sharma

  3. Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India

    Aliza Mittal

Authors
  1. Biangchwadaka Suchiang
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  2. Manish Pathak
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  9. Arvind Sinha
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Contributions

Data collection and statistical analysis - Biangchwadaka Suchiang. Study conceptualisation and design - Manish Pathak. Interpretational of ELISA tests for biomarkers - Shailja Sharma. Interpretation of results - Manish Pathak, Rahul Saxena, Aliza Mittal, Kirtikumar Rathod, Arvind Sinha. Critical revision and Finalising the manuscript - Manish Pathak, Rahul Saxena, Shubhalaxmi Nayak, Avinash Jadhav, Arvind Sinha. Supervision and guidance - Manish Pathak, Arvind Sinha.

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Correspondence to Manish Pathak.

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Suchiang, B., Pathak, M., Saxena, R. et al. Role of urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL), Monocyte Chemoattractant Protein-1(MCP-1), and Interleukin-6(IL-6) as biomarkers in pediatric patients with hydronephrosis. Pediatr Surg Int 38, 1635–1641 (2022). https://doi.org/10.1007/s00383-022-05207-x

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