First-year profile of biomarkers for early detection of renal injury in infants with congenital urinary tract obstruction

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author KOSTIC, Dusan FMUSP-HC
BEOZZO, Glenda Priscila Neves dos Santos FMUSP-HC
COUTO, Saulo Brasil do FMUSP-HC
KATO, Andre Henrique Teruaki FMUSP-HC
LIMA, Laila FMUSP-HC
PALMEIRA, Patricia FMUSP-HC
KREBS, Vera Lucia Jornada FMUSP-HC
BUNDUKI, Victor FMUSP-HC
FRANCISCO, Rossana Pulcineli Vieira FMUSP-HC
ZUGAIB, Marcelo FMUSP-HC
CARVALHO, Werther Brunow de FMUSP-HC
KOCH, Vera Hermina Kalika FMUSP-HC
dc.date.issued 2019
dc.identifier.citation PEDIATRIC NEPHROLOGY, v.34, n.6, p.1117-1128, 2019
dc.identifier.issn 0931-041X
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/32493
dc.description.abstract Background Diagnosis of renal function impairment and deterioration in congenital urinary tract obstruction (UTO) continues to be extremely challenging. Use of renal biomarkers in this setting may favor early renal injury detection, allowing for a reliable choice of optimal therapeutic options and prevention or minimization of definitive renal damage. Methods This longitudinal, prospective study analyzed the first-year profile of two serum renal biomarkers: creatinine (sCr) and cystatin C (sCyC); and six urinary renal biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), transforming growth factor beta-1 (TGF-beta 1), retinol-binding protein (RBP), cystatin C (mu CyC), and microalbuminuria (ALB) in a cohort of 37 infants with UTO divided into three subgroups: 14/37 with unilateral hydro(uretero)nephrosis, 13/37 with bilateral hydro(uretero)nephrosis, and 10/37 patients with lower urinary tract obstruction (LUTO), compared with 24 healthy infants matched by gestational age and birth weight. Results All urine biomarkers showed significantly higher values at the first month of life (p <= 0.009), while NGAL (p = 0.005), TGF-beta 1 (p<0.001), and mu ALB (p<0.001) were high since birth compared to controls. Best single biomarker performances were RBP in bilateral hydronephrosis and LUTO subgroups and KIM-1 in unilateral hydronephrosis subgroup. Best biomarker combination results for all subgroups were obtained by matching RBP with TGF-beta 1 or KIM-1 and NGAL with CyC ([AUC] <= 0.934; sensitivity <= 92.4%; specificity <= 92.8%). Conclusions RBP, NGAL, KIM-1, TGF-beta 1, and CyC, alone and especially in combination, are relatively efficient in identifying surgically amenable congenital UTO and could be of practical use in indicating on-time surgery.
dc.description.sponsorship · Sao Paulo Research Foundation-FAPESP Grant [2012/50337-9]
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Pediatric Nephrology
dc.rights restrictedAccess
dc.subject Congenital urinary tract obstruction; Hydronephrosis; Renal biomarkers; Infants
dc.subject.other ureteropelvic junction obstruction; cystatin-c; children; newborn; kidney; hydronephrosis; classification; dilatation; creatinine; management
dc.title First-year profile of biomarkers for early detection of renal injury in infants with congenital urinary tract obstruction
dc.type article
dc.rights.holder Copyright SPRINGER
dc.description.group LIM/36
dc.description.group LIM/57
dc.identifier.doi 10.1007/s00467-019-4195-4
dc.identifier.pmid 30694385
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author KOSTIC, Dusan:HC:ICR
hcfmusp.author BEOZZO, Glenda Priscila Neves dos Santos:HC:ICR
hcfmusp.author COUTO, Saulo Brasil do:FM:
hcfmusp.author KATO, Andre Henrique Teruaki:HC:ICHC
hcfmusp.author LIMA, Laila:HC:INCOR
hcfmusp.author PALMEIRA, Patricia:FM:
hcfmusp.author KREBS, Vera Lucia Jornada:HC:ICR
hcfmusp.author BUNDUKI, Victor:FM:MOG
hcfmusp.author FRANCISCO, Rossana Pulcineli Vieira:FM:MOG
hcfmusp.author ZUGAIB, Marcelo:FM:MOG
hcfmusp.author CARVALHO, Werther Brunow de:FM:MPE
hcfmusp.author KOCH, Vera Hermina Kalika:HC:ICR
hcfmusp.origem.id WOS:000468519900017
hcfmusp.origem.id 2-s2.0-85061047209
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1432-198X
hcfmusp.citation.wos 0


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