Korean J Urol.  2014 Oct;55(10):670-676. 10.4111/kju.2014.55.10.670.

Role of Urinary Levels of Endothelin-1, Monocyte Chemotactic Peptide-1, and N-Acetyl Glucosaminidase in Predicting the Severity of Obstruction in Hydronephrotic Neonates

• Mohammadjafari H
• Rafiei A
• Mousavi SA
• Alaee A
• Yeganeh Y

• KMID: 2069791
• DOI: http://doi.org/10.4111/kju.2014.55.10.670

Abstract

PURPOSE
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.
MATERIALS AND 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.

Keyword

Acetylglucosaminidase; Endothelin-1; Hydronephrosis; MCP1 protein; Neonate

MeSH Terms

Acetylglucosaminidase/*urine
Biological Markers/urine
Chemokine CCL2/*urine
Endothelin-1/*urine
Female
Humans
Hydronephrosis/*congenital/etiology/surgery/ultrasonography
Infant, Newborn
Male
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Ureteral Obstruction/complications/*diagnosis/surgery
Acetylglucosaminidase
Biological Markers
Chemokine CCL2
Endothelin-1

Figure

• 

  FIG. 1 Receiver operating characteristic (ROC) curve to detect severe obstruction (differentiate group 1 from group 2). (A) For endothelin-1 to creatinine ratio (ET-1/Cr), area under the curve (AUC)=0.657 (standard error [SE], 0.094; 95% confidence interval [CI], 0.473-0.841). (B) For monocyte chemotactic peptide-1 to creatinine ratio (MCP-1/Cr) ratio, AUC=0.732 (SE, 0.084; 95% CI, 0.568-0.896). (C) For N-acetyl-beta-D-glucosaminidase to creatinine ratio (NAG/Cr), AUC=0.627 (SE, 0.088; 95% CI, 0.500-0.844).

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