title: The role of urinary KIM-1, NGAL, CA19-9 and β2-microglobulin in the assessment of ureteropelvic junction obstruction in adults.
abstract: OBJECTIVE
  The objective of this study is to evaluate the diagnostic properties of urinary biomarkers in adults with ureteropelvic junction obstruction: KIM-1, NGAL, CA19-9, and β2-microglobulin. We also assessed urinary biomarker concentrations following pyeloplasty.
  
  
  METHODS
  We prospectively studied adults from December 2013 to February 2015. We included 47 patients with a mean age of 38.6 ± 12.7 years. Each patient provided four samples of voided urine for biomarker measurement, one at pre-operative consultation and the others at 1, 3, and 6 months of post-operative follow-up. The control group consisted of 40 healthy individuals with no hydronephrosis on ultrasound evaluation.
  
  
  RESULTS
  KIM-1 had an area under the curve of 0.79 (95% CI 0.70-0.89), NGAL 0.71 (95% CI 0.61-0.83), CA19-9 0.70 (95% CI 0.60-0.81), and β2-microgloblin 0.61 (95% CI 0.50-0.73). KIM-1 was the most sensitive marker with a cut-off of 170.4 pg/mg creatinine (sensitivity 91.4%, specificity 59.1%), whereas CA19-9 was the most specific with a cut-off of 51.3 U/mg creatinine (sensitivity 48.9%, specificity 88.0%). Urinary concentrations of biomarkers decreased after pyeloplasty.
  
  
  CONCLUSIONS
  The evaluation of urinary biomarkers is useful in adults undergoing pyeloplasty. KIM-1, NGAL, and CA19-9 were elevated and significantly decreased after surgery.
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Eduardo P
authors.identifier: http://orcid.org/0000-0002-3552-5400
authors.initials: EP
authors.lastname: Miranda
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Ricardo J
authors.identifier: http://orcid.org/0000-0002-7490-119X
authors.initials: RJ
authors.lastname: Duarte
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: José
authors.identifier: http://orcid.org/0000-0003-4833-4889
authors.initials: J
authors.lastname: de Bessa
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Roberto I
authors.identifier: http://orcid.org/0000-0002-6636-7679
authors.initials: RI
authors.lastname: Lopes
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Victor
authors.identifier: http://orcid.org/0000-0001-8346-3833
authors.initials: V
authors.lastname: Srougi
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Hiury S
authors.identifier: http://orcid.org/0000-0003-2521-0023
authors.initials: HS
authors.lastname: Andrade
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Rodolfo A S T
authors.identifier: http://orcid.org/0000-0001-8933-7096
authors.initials: RAST
authors.lastname: Bandeira
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Marco A
authors.identifier: http://orcid.org/0000-0002-2577-119X
authors.initials: MA
authors.lastname: Arap
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Anuar I
authors.identifier: http://orcid.org/0000-0002-7031-550
authors.initials: AI
authors.lastname: Mitre
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Nayara I
authors.identifier: http://orcid.org/0000-0003-4505-8508
authors.initials: NI
authors.lastname: Viana
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Sabrina T
authors.identifier: http://orcid.org/0000-0003-3967-0792
authors.initials: ST
authors.lastname: Reis
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Katia R M
authors.identifier: http://orcid.org/0000-0002-2615-7730
authors.initials: KRM
authors.lastname: Leite
authors.affiliation: a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
authors.forename: Miguel
authors.identifier: http://orcid.org/0000-0002-4545-0596
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine*; D018395:CA-19-9 Antigen / Q000652:urine; D016022:Case-Control Studies; D000072596:Hepatitis A Virus Cellular Receptor 1 / Q000032:analysis; D006801:Humans; D000071068:Lipocalin-2 / Q000652:urine; D008875:Middle Aged; D000074643:Nephrotomy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000601:surgery; D001613:beta 2-Microglobulin / Q000652:urine
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D001613:beta 2-Microglobulin
keywords: CA-19-9 antigen; Ureteral obstruction; beta 2-microglobulin; hydronephrosis; kidney injury molecule-1; lipocalins