title: Role of urinary levels of endothelin-1, monocyte chemotactic peptide-1, and N-acetyl glucosaminidase in predicting the severity of obstruction in hydronephrotic neonates.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Mohammadjafari
authors.affiliation: Molecular and Cell Biology Research Center, Hemoglubinopathy Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Rafiei
authors.affiliation: Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Seyed Abdollah
authors.initials: SA
authors.lastname: Mousavi
authors.affiliation: Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Abdulrasool
authors.initials: A
authors.lastname: Alaee
authors.affiliation: Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Yeganeh
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D018932:Chemokine CCL2 / Q000652:urine*; D019332:Endothelin-1 / Q000652:urine*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D019332:Endothelin-1; D000118:Acetylglucosaminidase
keywords: Acetylglucosaminidase; Endothelin-1; Hydronephrosis; MCP1 protein; Neonate