title: Urinary biomarkers in prenatally diagnosed unilateral hydronephrosis.
abstract: The introduction of prenatal ultrasonography as a screening method entails an increasing number of infants diagnosed with prenatal hydronephrosis. Ureteropelvic junction obstruction accounts for 35% of prenatal hydronephrotic cases. Urinary tract obstruction that occurs during early kidney development affects renal morphogenesis, maturation and growth, and in the most severe cases this will ultimately cause renal insufficiency. A major challenge in the clinical management of these patients is to preserve renal function by selection of the 15%-20% who require early surgical intervention, leaving those for whom watchful waiting may be appropriate because of spontaneous resolution/stabilization without significant loss of renal function. Today, this requires medical surveillance, including repetitive invasive diuretic renograms relying on arbitrary threshold values, and therefore there is a need for non-arbitrary, non-invasive urinary biomarkers that may be used as predictors for renal structural changes and/or decreasing renal function, and thereby provide the surgeon with more clear indications for surgical intervention. In this review, we summarize the currently well-known facts about urinary biomarkers in ureteropelvic junction obstruction concerning renal function, and we also suggest potential novel urinary biomarkers.
authors.affiliation: Institute of Clinical Medicine, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. miagebauermadsen@ki.au.dk
authors.forename: Mia Gebauer
authors.initials: MG
authors.lastname: Madsen
authors.forename: Rikke
authors.initials: R
authors.lastname: Nørregaard
authors.forename: Jørgen
authors.initials: J
authors.lastname: Frøkiær
authors.forename: Troels Munch
authors.initials: TM
authors.lastname: Jørgensen
mesh_terms: D015415:Biomarkers / Q000652:urine*; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000652:urine*; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000652:urine*; D016216:Ultrasonography, Prenatal
chemical_list: D015415:Biomarkers