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Updated: Jun 15, 2026
An Immature Murine Model of Reversible Unilateral Ureteral Obstruction
Published on: April 4, 2025
Urinary proteome analysis identifies infants but not older children requiring pyeloplasty
Jens Drube1, Petra Zürbig, Eric Schiffer
1Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Hannover, Germany. jens.drube@web.de
Insights
A new urine proteomic test effectively identifies ureteropelvic junction obstruction (UPJO) in infants. However, this non-invasive test is less accurate for diagnosing UPJO in older children, necessitating further research.
Area of Science:
- Pediatric Urology
- Proteomics
- Diagnostic Biomarkers
Background:
- Ureteropelvic junction obstruction (UPJO) affects 20% of pediatric patients, often requiring pyeloplasty.
- Early detection of high-grade UPJO is crucial to prevent long-term renal damage.
- A novel non-invasive urine proteomic test has emerged for early UPJO detection.
Purpose of the Study:
- To evaluate the efficacy of a novel urine proteomic test for UPJO detection in a pediatric cohort.
- To assess the test's performance in both infants and older children.
- To validate the proteomic pattern for identifying the need for pyeloplasty.
Main Methods:
- Prospective study of 27 children with hydronephrosis scheduled for diuretic renal scan (DR).
- Urinary proteome analysis using capillary electrophoresis coupled to mass spectrometry.
- Exclusion of patients with prior urinary tract surgery.
Main Results:
- Eleven of 27 children were diagnosed with relevant UPJO by DR.
- In children under 1 year, the proteomic test showed 83% sensitivity and 92% specificity for UPJO.
- In older children, sensitivity dropped to 20% and specificity to 66%.
Conclusions:
- The studied urinary proteome pattern accurately predicts the need for surgery in infants with UPJO.
- The proteomic test's diagnostic utility is limited in older children with UPJO.
- Further research is needed to refine proteomic diagnostics for older pediatric populations.
Abstract:
One out of every five children suffering from ureteropelvic junction obstruction (UPJO) requires pyeloplasty. This prevalence indicates an urgent necessity to identify high-grade UPJO as early as possible to avoid renal damage. A novel non-invasive proteomic urine test has recently been introduced that is able to detect these patients at an early stage. In the study reported here, we tested this approach to assess its use in our centre and to expand its application to older children. Twenty-seven children (median age 0.4 years, range 0.1-8.8 years) with hydronephrosis who had been scheduled a nuclear diuretic renal scan (DR) to identify urodynamically relevant UPJO were included in our prospective study. Patients with prior surgery of the urinary tract were excluded. The urinary proteome pattern was analysed using capillary electrophoresis coupled to mass spectrometry. Of the 27 children, 11 had a relevant UPJO diagnosed by the DR. In 19 children <1 year of age, urinary proteome analysis predicted obstruction with a sensitivity of 83% (5/6) and a specificity of 92% (12/13). However, in older patients, the sensitivity decreased to 20% (1/5) and specificity to 66% (2/3). Based on our results, the proteome pattern established by Decramer and co-workers predicts the need for surgery in infants but not in older children with UPJO.
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