R&D Areas | Nephrology | Nephropediatry

In nephropediatry, physicians are frequently confronted with ureteopelvic junction obstruction-induced hydronephrosis. The challenge is to predict at an early stage those children who do not naturally resolve this hydronephrosis and who need pyeloplasty.

Current techniques are not sufficient to make clear-cut decisions whether to perform pyeloplasty or not with the risk of unnecessary intervention on neonates or bad renal outcome due to untreated hydronephrosis. The cases without clear kidney damage need invasive and expensive continuous surveillance to evaluate the actual state of kidney and the necessity for pyeloplasty.

We analyzed urinary polypeptides form individuals with neonatal ureteropelvic junction (UPJ) obstruction to predict which individuals with this condition will evolve towards obstruction that needs surgical correction. We identified polypeptides that enabled diagnosis of the severity of obstruction and validated these biomarkers in urine collected in a prospective blinded study. Using these non-invasive biomarkers, we were able to predict, several months in advance and with 94% precision, the clinical evolution of neonates with UPJ obstruction.

Figure 1: Membership of urinary proteomic pattern of 36 newborns with intermediate UPJ obstruction and the clinical outcome of these individuals 9 month after group membership prediction. This resulted in 34 out of 36 correct predictions (94%).