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Urinary NGAL, cystatin C, β2-microglobulin, and osteopontin significance in hydronephrotic children

Pediatric Nephrology volume 27, pages 2099–2106 (2012)Cite this article

Abstract

Background

Ureteropelvic junction obstruction (UPJO) accounts for 35 % of all congenital hydronephrosis cases. The challenge in managing childhood hydronephrosis is to distinguish obstructive from nonobstructive cases and, thereby, identify patients requiring surgical intervention. This study aimed to examine four urinary proteins as potential biomarkers of obstruction in hydronephrosis.

Methods

Urine samples from 24 children with UPJO were collected pre-, peri-, and postoperatively, together with urine samples from healthy children. Neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (CyC), β2-microglobulin (β2-M), and osteopontin (OPN) in the samples were measured simultaneously using multiplex sandwich immunoassay technology.

Results

Compared with controls, NGAL and β2-M were significantly increased in urine from patients with obstructed kidneys at the time of surgery. This increase was followed by a decrease and stabilization to the same level as that of the controls. Furthermore, age was negatively correlated with preoperative urinary concentrations of CyC, β2-M, and OPN.

Conclusions

This study confirms increased concentrations of NGAL and β2-M in urine from obstructed kidneys and should be tested in larger studies to ascertain their ability to identify obstruction and to determine the importance of age-adjusted reference values.

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Acknowledgements

The authors thank the technicians at the Water and Salt Research Center, Aarhus University Hospital, Denmark, for expert technical assistance, and Professor Jørgen Thorup (Department of Pediatric Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark) for inclusion of patients into a pilot study

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Affiliations

  1. Department of Urology, Pediatric Section, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark

    Mia Gebauer Madsen, Lars Henning Olsen & Troels Munch Jørgensen

  2. The Water and Salt Research Center, Institute of Clinical Medicine, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200, Aarhus N, Denmark

    Mia Gebauer Madsen, Rikke Nørregaard & Jørgen Frøkiær

  3. Research Unit for Molecular Medicine, Aarhus University Hospital, Brendstrupgaardsvej 21, 8200, Aarhus N, Denmark

    Johan Palmfeldt

Authors
  1. Mia Gebauer Madsen
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  2. Rikke Nørregaard
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  3. Johan Palmfeldt
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  4. Lars Henning Olsen
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  5. Jørgen Frøkiær
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Correspondence to Mia Gebauer Madsen.

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Madsen, M.G., Nørregaard, R., Palmfeldt, J. et al. Urinary NGAL, cystatin C, β2-microglobulin, and osteopontin significance in hydronephrotic children. Pediatr Nephrol 27, 2099–2106 (2012). https://doi.org/10.1007/s00467-012-2217-6

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  • DOI: https://doi.org/10.1007/s00467-012-2217-6

Keywords

  • Hydronephrosis
  • Ureteropelvic junction obstruction
  • NGAL
  • Cystatin C
  • β2-microglobulin
  • Osteopontin