The role of biomarkers in determination of surgical indications and follow-up of congenital ureteropelvic junction stenosis

Introduction: Uretero-pelvic junction stenosis (UPJO) is a complete or partial obstruction of the passage of urine from the renal pelvis to the ureter, which can manifest clinically with a range of conditions from low-grade transient dilation to permanent renal damage. Urinary ultrasonography and nuclear scintigraphy play crucial roles in the diagnosis and followup of UPJO. However, the disadvantages of these tests may result in delayed diagnosis and treatment, and renal damage during follow-up. In our study, we aimed to determine the effectiveness of biomarkers, without individual differences, for diagnosing, treating, and monitoring patients with UPJO during postoperative followup. Material And Method: In this study, we prospectively evaluated the data of 54 patients diagnosed with UPJO, treated, and followed up postoperatively at the Inonu University Faculty of Medicine, Department of Pediatric Surgery, between 2019-2022, along with 10 control group children. We examined the presence of the BK polyomavirus in the urine of newborn babies with antenatal hydronephrosis and their mothers. Additionally, we analyzed oxidative stress index, thiol, disulfide, TNF-α, TGF-β, Pentraxin-3, and Vanin1 in blood samples, and NGAL in urine samples. These results were compared with ultrasound and scintigraphy data. Results: Among the patients included in the study, 47 (73.4%) were male and 17 (26.6%) were female. The mean age was 3.164 ± 3 years. Serum total thiol and urinary NGAL values were consistent with the SFU grouping and treatment grouping (Thiol; p=0.02, p=0.0339. NGAL; p=0.007, p=0.0017). A significant increase in postoperative Vanin-1 value was observed in nine patients with a DRF of 40% or less on preoperative scintigraphy and complete recovery following surgery (p=0.008). Conclusion: We propose that serum total thiol and urinary NGAL values may be helpful in categorizing patients with UPJO and determining surgical indications. Furthermore, Vanin-1 may serve as a clinically useful biomarker for postoperative follow-up. Keywords: Ureteropelvic Junction Obstruction, Biomarker, NGAL, Serum Total Thiol, Vanin-1.