Role of Urinary Levels of Endothelin-1, Monocyte Chemotactic Peptide-1, and N-Acetyl Glucosaminidase in Predicting the Severity of Obstruction in Hydronephrotic Neonates.
10.4111/kju.2014.55.10.670
- Author:
Hamid MOHAMMADJAFARI
1
;
Alireza RAFIEI
;
Seyed Abdollah MOUSAVI
;
Abdulrasool ALAEE
;
Yalda YEGANEH
Author Information
1. Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Sari, Iran. hamidmjaafari@yahoo.com
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Acetylglucosaminidase;
Endothelin-1;
Hydronephrosis;
MCP1 protein;
Neonate
- MeSH:
Acetylglucosaminidase/*urine;
Biological Markers/urine;
Chemokine CCL2/*urine;
Endothelin-1/*urine;
Female;
Humans;
Hydronephrosis/*congenital/etiology/surgery/ultrasonography;
Infant, Newborn;
Male;
Predictive Value of Tests;
Prospective Studies;
Sensitivity and Specificity;
Ureteral Obstruction/complications/*diagnosis/surgery
- From:Korean Journal of Urology
2014;55(10):670-676
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Antenatal hydronephrosis (AH) is found in 0.5%-1% of neonates. The aim of the study was to assess the urinary concentrations of 3 biomarkers, endothelin-1 (ET-1), monocyte chemotactic peptide-1 (MCP-1), and N-acetyl-glucosaminidase (NAG) in severely hydronephrotic neonates. MATERIALS AND METHODS: Neonates with a history of prenatal hydronephrosis were enrolled in the prospective study in 2 groups. Group 1 included neonates with severe forms of obstruction requiring surgical intervention and group 2 included neonates with milder forms of obstruction without any functional impairment. Fresh voided urinary levels of ET-1, MCP-1, and NAG were measured and their ratios to urinary Cr were calculated. RESULTS: Fourty-two neonates were enrolled into the 2 groups: group 1, 24 patients (21 male, 3 female); group 2, 18 neonates (16 male, 2 female). There were no statistically significant differences between urinary ET-1, NAG, MCP-1 values, and ET-1/Cr and NAG/Cr ratios in groups 1 and 2. The urinary MCP-1/Cr ratio was significantly higher in group 1 than in group 2. For comparison of groups 1 and 2, the cut-off values were measured as 0.5709 ng/mg (sensitivity, 75%; specificity, 67%; positive predictive value [PPV], 71%; negative predictive value [NPV], 71%), 0.927 ng/mg (sensitivity, 77%; specificity, 72%; PPV, 77%; NPV, 72%), and 1.1913 IU/mg (sensitivity, 62%; specificity, 67%; PPV, 68%; NPV, 60%) for ET-1/Cr, MCP-1/Cr, and NAG/Cr ratios, respectively. CONCLUSIONS: The urinary MCP-1/Cr ratio is significantly elevated in neonates with severe obstruction requiring surgical intervention. Based upon these results, urinary MCP-1/Cr may be useful in identification of severe obstructive hydronephrosis in neonates.
