The role of urinary KIM-1, NGAL, CA19-9 and β2-microglobulin in the assessment of ureteropelvic junction obstruction in adults

• Published in: Biomarkers Vol. 22; no. 7; pp. 682 - 688
• Main Authors: Miranda, Eduardo P., Duarte, Ricardo J., de Bessa, José, Lopes, Roberto I., Srougi, Victor, Andrade, Hiury S., Bandeira, Rodolfo A. S. T., Arap, Marco A., Mitre, Anuar I., Viana, Nayara I., Reis, Sabrina T., Leite, Katia R. M., Srougi, Miguel
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.11.2017
• Subjects: Adult; beta 2-microglobulin; beta 2-Microglobulin - urine; Biomarkers - urine; CA-19-9 antigen; CA-19-9 Antigen - urine; Case-Control Studies; Hepatitis A Virus Cellular Receptor 1 - analysis; Humans; hydronephrosis; kidney injury molecule-1; Lipocalin-2 - urine; lipocalins; Middle Aged; Nephrotomy; Prospective Studies; Sensitivity and Specificity; Ureteral obstruction; Ureteral Obstruction - diagnosis; Ureteral Obstruction - surgery; Ureteral obstruction; lipocalins; beta 2-microglobulin; CA-19-9 antigen; kidney injury molecule-1; hydronephrosis
• ISSN: 1354-750X; 1366-5804
• DOI: 10.1080/1354750X.2017.1284264

Purpose: 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. Material and 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.