title: Renal parenchymal thickness and urinary protein levels in patients with ureteropelvic junction obstruction after nephrostomy placement.
abstract: OBJECTIVE
  To assess recovery of renal parenchymal thickness and urinary protein levels in patients with severely hydronephrotic kidneys after nephrostomy placement.
  
  
  METHODS
  Fourteen patients (median age 1 year, range 6 months-7 years) who underwent nephrostomy placement for unilateral ureteropelvic junction obstruction at our hospital between May 2007 and January 2009 were included in a retrospective analysis. All patients had severe hydronephrosis, with a median parenchymal thickness of 1.8 mm (range 1-2.5 mm). Kidney morphology was examined by ultrasound before the procedure and 1, 2, 3, 4, 6 and 8 weeks after. Urinary proteins (including albumin, immunoglobulin [IgG], alpha2-macroglobulin, alpha1-microglobulin, beta2-microglobulin [beta2-MG] and kappa chain) and creatinine levels were also tested during these follow-up visits. Fifteen healthy children were assessed for urinary protein levels as well and made up the control group.
  
  
  RESULTS
  Parenchymal thickness increased within 4 weeks of nephrostomy placement. Kidney volumes were significantly decreased within 2 weeks. No further changes in morphology were detected after 4 weeks. Urinary alpha1-microglobulin and beta2-MG levels decreased to baseline within 1 and 4 weeks, respectively. Urinary albumin, IgG, alpha2-macroglobulin and kappa chain levels decreased gradually after nephrostomy, but did not return to baseline within 8 weeks.
  
  
  CONCLUSIONS
  After nephrostomy placement, parenchymal thickness increases within 4 weeks, tubular function returns to normal earlier than glomerular function and glomerular membrane repair is inversely correlated with the severity of damage.
authors.affiliation: Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guang Zhou, China. denggaoyanemail@163.com
authors.forename: Gao-Yan
authors.initials: GY
authors.lastname: Deng
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Sun
authors.forename: Pa
authors.initials: P
authors.lastname: Wang
authors.forename: Jia-Cong
authors.initials: JC
authors.lastname: Mo
mesh_terms: D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D005916:Globulins / Q000652:urine; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D007074:Immunoglobulin G / Q000652:urine; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D009403:Nephrostomy, Percutaneous; D057234:Preoperative Period; D011507:Proteinuria / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography; D014513:Ureter / Q000000981:diagnostic imaging; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D013520:Urologic Surgical Procedures
chemical_list: D005916:Globulins; D007074:Immunoglobulin G; D003404:Creatinine