Role of Urinary Biomarkers in the Diagnosis and Prognosis of Children with ureteropelvic junction obstruction

Abstract

There are limited reports on the role of urinary biomarkers diagnosis prognosis of children with ureteropelvic junction obstruction UPJO The aim is to document the utility of carbohydrate antigen CA 19-9 neutrophil gelatinase associated lipocalin NGAL and kidney injury molecule KIM 1 in the diagnosis and prognosis of children with UPJO Controls were normal children while non obstructive dilatation NOD were children whose hydronephrosis resolved during follow up Study group included children with UPJO who worsened on ultrasound renogram or those who became symptomatic and underwent pyeloplasty Urinary biomarkers NGAL KIM 1 and CA 19 9 were measured in controls NOD study group before pyeloplasty at 6 weeks and 6 months after stent removal Surgical outcomes were assessed by reduction improvement on ultrasound or renogram The urine CA 19 9 NGAL and KIM 1 levels were significantly higher P value of 0 Point 001 in the UPJO group than NOD and controls Receiver operating characteristic analysis of CA 19 9 revealed a urine biomarker cutoff of 95 U per mL for diagnosing UPJO sensitivity 95 out of 100 specificity 96 out of 100 AUC 0 Point 99 Combining all three biomarkers or combining USG parameters with individual biomarkers increases the diagnostic ability of the biomarkers Urinary CA 19 9 NGAL and KIM 1 levels showed a significant fall following pyeloplasty p value of 0 Point 001 at 6 weeks and 6 months post op period newlineUrinary CA 19 9 is superior to NGAL and KIM 1 in identifying children with UPJO Biomarker levels drop significantly after a successful pyeloplasty suggesting their role in prognosis This present study establishes the utility of biomarkers in the diagnosis and prognosis of children with UPJO Further larger studies are warranted newline newline