Diagnostic significance of urinary transforming growth factor–β1 in the management of children with moderate to high grade pelvic-ureteric junction obstruction

Abstract

Objective: The aim of the present study is to evaluate the role of urinary transforming growth factor – β1 (uTGF-β1) in congenital unilateral pelvi-ureteric junction obstruction (PUJO) upto the point of developing conventional indications for surgery and after pyeloplasty with the aim to explore the development of targeted therapeutic strategies aimed at modulating its effects and attenuating renal fibrosis. Methods: Sixty two children with unilateral pelvi-ureteric junction obstruction, consisting of 46 boys and 16 girls, with a mean age of 9.4 months forms the study group. Twenty three out of 62 (37.1%) developed indication for surgery after a mean follow-up of 24.2±3.7 months. The uTGF-β1 levels have been measured by ELISA at different points of intervals, i.e., before indications for surgery, at the development of indications for surgery and after surgical intervention and compared with children continued to followon without indications for surgery. Results: In children, who were continued to be followed up without indications for surgery, 39 had a mean baseline uTGF-β1 levels of 698.4mg/pg/Cr. which increased to 753.1mg/pg/Cr. (p valuie <0.001) after a follow-up of 24.1 months). As the children developed indications for surgery and subsequently underwent surgical intervention (n = 23), the mean uTGF-β1 baseline levels of 760.4mg/pg/Cr. were increased to 844.4mg/pg.Cr. just before the point of surgical intervention. Conclusion: Urinary TGF-β1, hold the promise as a potential tool in the diagnosis and follow-up of hydronephrosis. The current evidence suggests that raised uTGF-β1 levels can effectively identify hydronephrosis with early parenchymal injury.

Keywords

• utgf-β1
• pelvi-ureteric junction obstruction (pujo)
• transforming growth factor-β (tgf-β)