title: Urinary proteome analysis identifies infants but not older children requiring pyeloplasty.
abstract: One out of every five children suffering from ureteropelvic junction obstruction (UPJO) requires pyeloplasty. This prevalence indicates an urgent necessity to identify high-grade UPJO as early as possible to avoid renal damage. A novel non-invasive proteomic urine test has recently been introduced that is able to detect these patients at an early stage. In the study reported here, we tested this approach to assess its use in our centre and to expand its application to older children. Twenty-seven children (median age 0.4 years, range 0.1-8.8 years) with hydronephrosis who had been scheduled a nuclear diuretic renal scan (DR) to identify urodynamically relevant UPJO were included in our prospective study. Patients with prior surgery of the urinary tract were excluded. The urinary proteome pattern was analysed using capillary electrophoresis coupled to mass spectrometry. Of the 27 children, 11 had a relevant UPJO diagnosed by the DR. In 19 children <1 year of age, urinary proteome analysis predicted obstruction with a sensitivity of 83% (5/6) and a specificity of 92% (12/13). However, in older patients, the sensitivity decreased to 20% (1/5) and specificity to 66% (2/3). Based on our results, the proteome pattern established by Decramer and co-workers predicts the need for surgery in infants but not in older children with UPJO.
authors.affiliation: Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany. jens.drube@web.de
authors.forename: Jens
authors.initials: J
authors.lastname: Drube
authors.forename: Petra
authors.initials: P
authors.lastname: Zürbig
authors.forename: Eric
authors.initials: E
authors.lastname: Schiffer
authors.forename: Esther
authors.initials: E
authors.lastname: Lau
authors.forename: Benno
authors.initials: B
authors.lastname: Ure
authors.forename: Sylvia
authors.initials: S
authors.lastname: Glüer
authors.forename: Martin
authors.initials: M
authors.lastname: Kirschstein
authors.forename: Lars
authors.initials: L
authors.lastname: Pape
authors.forename: Stéphane
authors.initials: S
authors.lastname: Decramer
authors.forename: Jean-Loup
authors.initials: JL
authors.lastname: Bascands
authors.forename: Joost P
authors.initials: JP
authors.lastname: Schanstra
authors.forename: Harald
authors.initials: H
authors.lastname: Mischak
authors.forename: Jochen H H
authors.initials: JH
authors.lastname: Ehrich
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000652:urine; D002648:Child; D002675:Child, Preschool; D019075:Electrophoresis, Capillary; D005260:Female; D005858:Germany; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery / Q000652:urine; D007223:Infant; D008297:Male; D013058:Mass Spectrometry; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology / Q000503:physiopathology / Q000601:surgery* / Q000652:urine*; D040901:Proteomics / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000150:complications / Q000503:physiopathology / Q000601:surgery* / Q000652:urine*; D014563:Urodynamics; D013520:Urologic Surgical Procedures
chemical_list: D015415:Biomarkers