valuating TIMP-2 and IGFBP-7 as a predictive tool for kidney injury in ureteropelvic junction obstructio

Author(s)

Mello, Marcos Figueiredo ^[1] ; de Bessa Junior, Jose ^[2] ; Reis, Sabrina T. ^[3] ; Kondo, Enzo Yagi ^[3] ; Yu, Luis ^[4] ; Denes, Francisco Tibor ^[1] ; Lopes, Roberto Iglesias ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin, Unidade Urol Pediat, Div Urol, Av Dr Eneas Carvalho de Aguiar 255, BR-05403000 Sao Paulo, SP - Brazil

^[2] Univ Estadual Feira de Santana, Div Urol, Feira De Santana, BA - Brazil

^[3] Univ Sao Paulo, Fac Med, Div Urol, Lab Invest Med LIM55, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Fac Med, Hosp Clin, Div Nefrol, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: INTERNATIONAL BRAZ J UROL; v. 48, n. 2, p. 284-293, MAR-APR 2022.
• Web of Science Citations: 0

Abstract

A major challenge in the management of ureteropelvic junction obstruction (UPJO) is the selection of patients who would benefit from surgical treatment. Tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) indicate renal cell stress and are associated with cell cycle arrest. The {[}TIMP-2] {[}IGFBP7] ratio (Nephrocheck (R)) has been recently applied in patients in intensive care units patients to predict the development of acute kidney injury. In this study, we evaluated the performance of these biomarkers performance to distinguishing obstructive hydronephrosis (HN) from non-obstructive HN. Materials and Methods: Consecutive patients with UPJO were enrolled in this study. Urinary {[}TIMP-2] {[}IGFBP7] and clinical characteristics (hydronephrosis grade, differential renal function, and drainage half-time) were measured in the following groups: 26 children with obstructive HN at initial diagnosis (group IA) and after six months of dismembered pyeloplasty (group 1B); 22 children with non-obstructive HN (group 2), and 26 children without any urinary tract condition, as the control group (group 3). Results: Comparing the initial samples, {[}TIMP-2] {[}IGFBP7] had higher levels in the HN groups and lower levels in the control group; however, no difference was observed between the HN groups (obstructive vs. non-obstructive). After six months of followup, patients who underwent dismembered pyeloplasty showed stability in the urinary concentration of {[}TIMP-2] {[}IGFBP7]. All patients with {[}TIMP-2] {[}IGFBP7] higher than 1.0 (ng/mL)(2)/1000 had diffuse cortical atrophy on ultrasonography. Conclusions: We showed that urinary levels of urinary {[}TIMP-2] {[}IGFBP7] are higher in children with HN than controls. Nephrocheck (R) is not reliable in predicting the need for surgical intervention for pediatric patients with UPJO. (AU)

• FAPESP's process: 17/08224-6 - The role of urinary biomarkers in the assessment of ureteropelvic junction obstruction
• Grantee: Roberto Iglesias Lopes
• Support Opportunities: Regular Research Grants