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CONGRESS OF THE ESPU
14:24–14:27
S1-12 (PP)
URINARY IP-10, MCP-1, NGAL, CA19-9 AND KIM-1 LEVELS
IN SUPRANORMAL RENAL FUNCTION WITH UNILATERAL
HYDRONEPHROSIS
Omer Baris YÜCEL
1
, Canan KÜÇÜKGERGIN
2
, Haluk ANDER
1
, Muhammet
Irfan DÖNMEZ
1
, Unsal OZKUVANCI
1
, Orhan ZIYLAN
1
and Tayfun OKTAR
1
1) Istanbul University Istanbul Faculty of Medicine, Urology, Istanbul, TURKEY - 2) Istanbul University Istanbul Faculty
of Medicine, Biochemistry, Istanbul, TURKEY
PURPOSE
The aim of this study is to investigate the urinary interferon gamma-induced protein 10(IP-10),
monocyte chemotactic protein-1(MCP-1), neutrophil gelatinase-associated lipocalin(NGAL),
cystatin-C and kidney injury molecule-1(KIM-1)levels in children with antenatally diagnosed uni-
lateral hydronephrosis(ANH) and supranormal renal function(SnDRF) and to evaluate the clinical
significance.
MATERIAL AND METHODS
A total of 53 children with unilateral ANH were enrolled into the study.They were divided into
2 groups as 20 children with SnDRF and 33 children with reduced DRF.On follow up, pyeloplasty
was performed to 6 of the 20 children with SnDRF(mean DRF:54.7%+/-3.1) and 19 of 33 children
with reduced DRF.The remaining children were classified as having non-obstructive dilation(NOD)
in both SnDRF(14 children) and reduced DRF(14 children) groups.19 children were enrolled in the
control group.The urinary biomarker levels of these 72 children were measured.
RESULTS
The urinary levels of all biomarkers were significantly higher in children who underwent pyelo-
plasty compared to controls (p<0.001).There was no significant difference between the obstructive
and SnDRF/obstructive groups or between the NOD and SnDRF/NOD groups regarding of all
biomarker levels(p<0.001).Urinary NGAL and CA19-9 levels in obstructive/SnDRF group were
significantly higher than the children with SnDRF and NOD(p=0.033;p=0.005). Urinary NGAL(cut-
off value:13.9ng/mg creatinine) and CA19-9(cut-off value:113.85 U/mg creatinine) can determine
the need of surgery in SnDRF group with 83% and 100% sensitivity, 86% and 79% specificity,
respectively. Urinary MCP-1 showed 80% sensitivity, 79% specificity to identify 25 children who re-
quired surgery. Urinary IP-10 and KIM-1 can differentiate between obstructive and non-obstructive
dilatation in SnDRF group with 83% sensitivity, 57% and 71% specificity,respectively.
CONCLUSIONS
We demonstrated that the unilateral hydronephrosis of children with SnDRF could be obstructive
or non-obstructive for the first time using biomarkers. The need of pyeloplasty for a child with or
without SnDRF could be predicted with 90% sensitivity and 80% specificity using the combination
of these biomarkers.