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Urinary biomarkers in children with neurogenic and non-neurogenic lower urinary tract dysfunction: A systematic
Cagri Akin Sekerci1, Selcuk Yucel1, Tufan Tarcan1,2
1Department of Urology, Division of Pediatric Urology, School of Medicine, Marmara University, Istanbul, Turkey.
Insights
Urinary biomarkers like nerve growth factor (NGF) show promise for diagnosing lower urinary tract dysfunction (LUTD) in children. Further research is needed to confirm their clinical utility in non-invasive diagnostics.
Area of Science:
- Pediatric Urology
- Biomarker Research
- Urology
Background:
- Lower urinary tract dysfunction (LUTD) affects children, encompassing both neurogenic and non-neurogenic conditions.
- Accurate diagnosis and monitoring of LUTD are crucial for effective management in pediatric populations.
- Non-invasive diagnostic tools are highly desirable for pediatric patients.
Conclusions:
- Urinary biomarkers demonstrate potential as non-invasive tools for diagnosing LUTD in children.
- Further prospective studies with larger cohorts are essential to validate the role of these biomarkers in reflecting urodynamic and clinical outcomes.
Aim:
The aim of this systematic review is to assess urinary biomarkers studied in children with neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD).
Materials And Methods:
The systematic review was conducted in accordance with the PRISMA guidelines. The screening was performed on PUBMED without any publication date limitation. Only original articles were included. Parameters related to the following topics were obtained: study design, characteristics of participants, number of participants, age, control group, types of biomarkers, measurement technique in urine, subgroup analysis, urodynamic findings, and outcome. Dutch Cochrane Checklist (DCC) and level of evidence by EBRO platform were used for quality assessment. Meta-analysis was performed with the Comprehensive Meta-Analysis Version 4 program.
Results:
A total of 494 studies were screened and 16 studies were included. 11 (68.75%) were conducted in children with non-neurogenic LUTD and 5 (31.25%) neurogenic LUTD. Nerve growth factor (NGF) was evaluated in 12 studies, brain-derived neurotrophic factor (BDNF) in 5, Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) in 2, transforming growth factor beta-1 (TGF Beta-1) in 2, neutrophil gelatinase-associated lipocalin (NGAL) in 1, and Aquaporin-2 in 1. According to DCC, 10 (62.5%) articles were evaluated on 4 (37.5%) items and 4 articles on 5 items. The average score was 3.91+/-0.56. The level of evidence was found as B for 13 (81.25%) articles and C for 3 (18.75%). In meta-analysis, urinary NGF levels in children with non-neurogenic LUTS were significantly higher than in the healthy control group (Hedges's g = 1.867, standard error = 0.344, variance = 0.119, p = 0.0001).
Conclusion:
Urinary biomarkers are promising for the future with their noninvasive features. However, prospective studies with larger sample sizes are needed to better understand the potential of urinary biomarkers to reflect urodynamic and clinical findings in children with LUTD.
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