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Proteomic Profile of EPS-Urine through FASP Digestion and Data-Independent Analysis
14:48

Proteomic Profile of EPS-Urine through FASP Digestion and Data-Independent Analysis

Published on: May 8, 2021

Urinary proteome analysis to exclude severe vesicoureteral reflux

Jens Drube1, Eric Schiffer, Esther Lau

  • 1Clinic of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. jens.drube@web.de

Pediatrics
|January 25, 2012
PubMed

Insights

A new noninvasive urinary proteome test accurately identifies high-grade vesicoureteral reflux (VUR) in children with urinary tract infections (UTI). This test can help avoid unnecessary invasive diagnostics for most children.

Area of Science:

  • Urology
  • Pediatric Nephrology
  • Biomarker Discovery

Background:

  • High-grade vesicoureteral reflux (VUR) (grade IV-V) is a significant risk factor for renal scarring, impaired kidney function, and hypertension.
  • Current gold standard for VUR diagnosis, voiding cystourethrography (VCUG), is invasive.
  • Most children with urinary tract infection (UTI) do not have high-grade VUR, leading to unnecessary invasive procedures.

Purpose of the Study:

  • To develop and validate a noninvasive diagnostic test for identifying high-grade VUR in children.
  • To reduce the need for invasive diagnostics in the majority of children presenting with UTI.

Main Methods:

  • A case-control study utilized capillary electrophoresis coupled to mass spectrometry to establish a urinary proteome pattern.
  • The proteome pattern distinguished 18 children with VUR grade IV-V from 19 controls without VUR after UTI.
  • Independent validation was performed in a blinded cohort of 17 VUR patients and 19 controls.

Main Results:

  • The noninvasive test demonstrated 88% sensitivity and 79% specificity for detecting VUR grade IV-V in the blinded cohort.
  • Test accuracy was independent of patient age, gender, and contralateral kidney VUR grade.
  • A positive test result yielded an odds ratio of 28 for having high-grade VUR.

Conclusions:

  • A novel noninvasive urinary proteome test shows promise for identifying high-grade VUR in children with UTI.
  • This test is ready for prospective validation in larger cohorts.
  • The test could spare children without pathological proteome patterns from further invasive diagnostics like VCUG.
Abstract

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