Abstract
Non-invasive prognosis of the clinical progression of disease is of high interest, especially in newborn and children. Neonatal ureteropelvic (UPJ) junction obstruction needs close and invasive surveillance to determine the necessity of pyeloplasty. A number of groups have initiated research with the aim to find non-invasive biomarkers for UPJ obstruction. Two different strategies have been followed. One strategy, based on the knowledge obtained in animal models of UPJ obstruction, has identified a number of individual urinary markers of severe UPJ obstruction. Combining these markers might allow prediction of which patients will require surgery and in which patients UPJ obstruction will spontaneously resolve. The other strategy is based on urinary proteomics. In this strategy the entire urinary proteome is probed for a set of biomarkers that correlates with the degree of UPJ obstruction. In subsequent steps, these sets of urinary biomarkers are used for prediction of the clinical evolution of UPJ obstruction patients. This proteomic-based strategy allowed prediction, several months in advance, of the clinical evolution of neonates with UPJ-obstruction. Both strategies will be complementary and will hopefully replace in the near future the invasive follow-up of newborns with UPJ obstruction.
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This work was supported by grants from the Clinical Research Hospital Program from the French Ministry of Health (PHRC 2004) and from the “Fondation pour la Recherche Médicale” call “Development and therapy for kidney diseases”. Regulatory and ethic submission was sponsored by University Hospital of Toulouse. The work of J.P. Schanstra was supported by Inserm and the “Direction Régional de la Recherche” (CHU de Toulouse) under the Interface programme.
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Decramer, S., Bascands, JL. & Schanstra, J.P. Non-invasive markers of ureteropelvic junction obstruction. World J Urol 25, 457–465 (2007). https://doi.org/10.1007/s00345-007-0201-8
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DOI: https://doi.org/10.1007/s00345-007-0201-8