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11–14 APRIL, 2018, HELSINKI, FINLAND
16:20–16:23
S3-9 (PP)
NGAL, TGF-BETA1 AND L-FABP URINARY LEVELS
IN THE DIAGNOSIS AND FOLLOW-UP OF CHILDREN WITH
URETEROPELVIC JUNCTION OBSTRUCTION (UPJO)
Anna LASZKOWSKA, Andrzej GOLEBIEWSKI, Leszek KOMASARA and
Piotr CZAUDERNA
Medical University of Gdansk, Surgery and Urology for Children and Adolescents, Gdansk, POLAND
PURPOSE
The aim of the study was to evaluate the role of transforming growth factor-beta1 (TGF-β1), neu-
trophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid-binding proteins (L-FABP) in the
diagnosis and follow-up of children with UPJO.
MATERIAL AND METHODS
The study cohort consisted of 31 patients with severe UPJO (SFU Grade III and IV) who required
surgery (median age 1,3 years) and matched control group of 15 healthy children. Urinary NGAL,
TGF-β1 and L-FABP were measured in renal pelvic intraoperatively and in bladder urine preopera-
tively and 12 and 24 months after surgery. Bladder urine biomarkers were also measured in 15 age
matched children without UPJO. All of the children had normal renal function.
RESULTS
In the obstructed group mean NGAL, TGF-β1 and L-FABP in the renal pelvic urine was
734,43±329,8 pg/ml, 102,79±34,1 pg/ml, 15,56±7,6 pg/ml respectively, or 1,7–3,4-fold that of blad-
der urine (p <0.001). Mean bladder urine NGAL, TGF-β1 and L-FABP were 433,7±193,2 pg/ml,
54,2±31,9 pg/ml, 4,6±2,8 pg/ml respectively or 4,2–65,7-fold higher in patients with UPJO than in
controls (6,6±4,3 pg/ml, 12,3±8,9 pg/ml, 0,2±0,2 pg/ml, p <0.001) respectively.
Mean bladder NGAL, TGF-β1 and L-FABP 12 and 24 months after surgery showed a trend towards
a decrease, albeit still insignificant (187,7± 67,5 and 92,2±27,6 pg/ml, 42,0±18,9 and 28,73±14,3 pg/
ml, 2,6±1,2 and 1,3±0.9 pg/ml, respectively), p <0.08).
24 months post-operatively a significant decrease in the AP diameter of the renal pelvis
31,9±4,7 mm vs. 11.7±4,3 mm) (p < 0.01) and significant improvement in renal function (45,7±6,7 %
vs 48,8±6,5 %) (p < 0.05) were observed.
CONCLUSIONS
The measurement of urinary NGAL, TGF-β1 and L-FABP could become a useful tool for the di-
agnosis of obstructive hydronephrosis and the evaluation of the kidney function status, pre- and
postoperatively. Elevated levels of biomarkers after surgery may indicate permanent kidney injury
due to hydronephrosis despite successful repair of UPJO.