Obstructed Versus Dilated Nonobstructed Kidneys in Children With Congenital Ureteropelvic Junction Narrowing: Role of Urinary Tubular Enzymes

Abstract

Voided urinary N-acetyl-beta-D-glucosaminidase, alkaline phosphatase and gamma-glutamyl transferase are accurate markers for differentiating between children with ureteropelvic junction obstruction requiring pyeloplasty and those with dilated nonobstructed kidneys suitable for conservative treatment. Measurement of these enzymes in voided urine could be used as a noninvasive tool for long-term followup of children with ureteropelvic junction obstruction after pyeloplasty and those receiving conservative treatment.

Urinary biomarkers in prenatally diagnosed unilateral hydronephrosis

“…Potential urinary biomarkers in prenatally diagnosed unilateral hydronephrosis.ALP was the most effective way of measuring, giving a sensitivity of 100%, a specificity of 80% and an overall accuracy of 94%[38]. Taha et al suggest the use of these urinary enzymes as non-invasive markers for long-term follow up of children with UPJO.…”

Obstructive renal injury: from fluid mechanics to molecular cell biology

“…180 Interestingly, most of these urinary biomarkers take several months to regress to normal values after pyeloplasty, reflecting the fact that the initial obstruction sets in motion local, self-sustained inflammatory and tissue repair events. 167,175,179 An alternative approach involves large-scale unbiased gene expression profiling using transcriptomic array techniques or unbiased urine proteomic profiling. These tech- Obstructive renal injury Dovepress submit your manuscript | www.dovepress.com Dovepress niques are not based on prior physiopathological knowledge.…”

Obstructive renal injury: from fluid mechanics to molecular cell biology

“…167,176 Urinary tubular enzymes, such as N-acetyl-beta-Dglucosaminidase (NAG), gamma-glutamyl transferase (GGT) and alkaline phosphatase (AP) have been evaluated for diagnostic and prognostic value in clinical UTO. [177][178][179] The combination of NAG and AP was reported to have a sensitivity of 100%, a specificity of 80% and an overall accuracy of 94% for differentiating between children with ureteropelvic junction obstruction requiring pyeloplasty and those with dilated nonobstructed kidneys suitable for conservative treatment (Table 2). 179 However urinary tubular enzymes are nonspecific markers of tubular injury and are elevated in other renal diseases.…”

“…[177][178][179] The combination of NAG and AP was reported to have a sensitivity of 100%, a specificity of 80% and an overall accuracy of 94% for differentiating between children with ureteropelvic junction obstruction requiring pyeloplasty and those with dilated nonobstructed kidneys suitable for conservative treatment (Table 2). 179 However urinary tubular enzymes are nonspecific markers of tubular injury and are elevated in other renal diseases. 180 Interestingly, most of these urinary biomarkers take several months to regress to normal values after pyeloplasty, reflecting the fact that the initial obstruction sets in motion local, self-sustained inflammatory and tissue repair events.…”

“…180 Interestingly, most of these urinary biomarkers take several months to regress to normal values after pyeloplasty, reflecting the fact that the initial obstruction sets in motion local, self-sustained inflammatory and tissue repair events. 167,175,179 An alternative approach involves large-scale unbiased gene expression profiling using transcriptomic array techniques or unbiased urine proteomic profiling. These tech- Notes: UPJO is related to UPJO with criteria for surgery unless otherwise stated.…”