Table 5.
Urinary proteins from studies in children with pelvi-ureteric junction obstruction
| Urinary protein (corrected for creatinine)a | Primary measured group | Comparators | Bladder urine protein level | Sensitivity/specificity/accuracyb | Post-operative bladder urine (compared to pre-operative) | Ref |
|---|---|---|---|---|---|---|
| ALP | Pyeloplasty | CMP | Increased pre-operative | Se 91.4%/ Sp 100%/ Ac 94% | Decreased 12 months post-operative | [168] |
| Angiotensinogen | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 93.3%c/ Sp 60%c | [169] | |
| B2-microglobulin | PUJO* | Healthy control | Increased | Decreased 42 months post-operative | [170] | |
| B2-microglobulin | Pyeloplasty | Healthy control | No change | [171] | ||
| Ca19-9 | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 76%d/Sp 85%d | Decreased 3 months post-operative | [172] |
| Ca19-9 | Pyeloplasty | Healthy control Hydrocoele/renal cyst |
Increased pre-operative | Se 100%e/ Sp 82.6%e | Decreased 3 months post-operative | [173] |
| CyC | Pyeloplasty | Healthy control | No change | [171] | ||
| EGF | PUJO* | Healthy control | Decreased (obstructed group only) | No change | [170] | |
| EGF | Pyeloplasty | Healthy control | Decreased pre-operative | Increased | [174] | |
| EGF | Pyeloplasty | Healthy control | Increased pre-operative | Se 70.4%/Sp 69.2% | Decreased 3 months and 1 year post-operative | [175] |
| EGF | Pyeloplasty | Healthy control | No change | [176] | ||
| ET-1 | Pyeloplasty | Healthy control VUR Renal stones |
Increased pre-operative | Se 74.3%/Sp 90%/ Ac 81.5% | Decreased 12 months post-operative | [177] |
| γGT | Pyeloplasty | CMP | Increased pre-operative | Se 62.9%/Sp 100%/Ac 74% | Decreased 12 months post-operative | [168] |
| HO-1 | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 72.2%c/Sp 78.1%c | Decreased 1 month post-operative | [178] |
| IP-10 | Pyeloplasty | Healthy control | No change | [175] | ||
| KIM-1 | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 100%c/Sp 71.4%c | [179] | |
| MCP-1 | Pyeloplasty | Healthy control | Increased pre-operative | Se 77.8%/Sp 69.2% | Decreased 3 months and 1 year post-operative | [175] |
| MCP-1 | PUJO* | Healthy control | Increased | Decreased 42 months post-operative | [170] | |
| MCP-1 | Pyeloplasty | Healthy control | Increased pre-operative | [174] | ||
| MCP-1 | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 100%c/Sp 0%c | Remains high 3 months post-operative | [180] |
| MIP-1α | Pyeloplasty | Healthy control | Decreased pre-operative | Increased 1 year post-operative | [175] | |
| NAG | Pyeloplasty | CMP | Increased pre-operative | Se 97.1%/Sp 80%/Ac 92% | Decreased 12 months post-operative | [168] |
| NGAL | Pyeloplasty | Healthy control | No change | [171] | ||
| NGAL | Pyeloplasty | Healthy control | Increased pre-operative | [181] | ||
| NGAL | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 100%c/Sp 28.6%c | Decreased 3 months post-operative | [179] |
| OPN | Pyeloplasty | Healthy control | No change | [171] | ||
| OPN | Pyeloplasty | Healthy control CMP |
Increased pre-operative | Se 98.5%c/Sp 10.5%c | Remains high 3 months post-operative | [180] |
| RANTES | Pyeloplasty | Healthy control | No change | [175] | ||
| TGF-β | Pyeloplasty | Healthy control | Increased pre-operative | Se 100%/Sp 80%/Ac 90.8% | Decreased 1 year post-operative | [176] |
| TGF-β | Pyeloplasty | CMP | Increased pre-operative | Se 82%/Sp 86% | [182] |
Generally, the primary group measured is children undergoing pyeloplasty; these children are then compared to healthy controls and/or conservatively managed children with PUJO (CMP). The exception in the studies listed in the table is labelled PUJO*, which includes children with conservatively managed PUJO split into ‘functional’ (t1/2 of renogram < 0 min) and ‘obstructed’ (t1/2 of renogram > 20 min). In these studies voided urine from children undergoing pyeloplasty was only obtained 42 months post-operative
aALP, Alkaline phosphatase; Ca19-9, carbohydrate antigen 19–9; CyC, cystatin-C; HO-1, heme oxygenase-1; γGT, gamma-glutamyl transferase; IP-10, interferon-γ-inducible protein 10; KIM-1, kidney injury molecule-1; MIP-1α, macrophage inflammatory protein-1α; NAG, N-acetyl-beta-D-glucosaminidase; NGAL, neutrophil gelatinase-associated lipocali; OPN, osteopontinn, RANTES, regulated on activation normal T-cell expressed and secreted
bWhere applicable sensitivity (Se), specificity (Sp) and accuracy (Ac) of the test at best threshold value from receiver operating characteristic curve analysis is presented
cTo detect differential renal function (DRF) of <40% out of all hydronephrosis cases
dTo detect pyeloplasty cases out of all hydronephrosis cases
eTo detect pyeloplasty cases out of all cases