Is BMP-7 a promising diagnostic and prognostic biomarker for pediatric obstructive uropathy?

Obstructive uropathy remains a major contributor to pediatric chronic kidney disease. Reliable biomarkers that predict disease progression or recovery are still lacking. Bone morphogenetic protein-7 (BMP-7), known for its anti-fibrotic and renoprotective properties, has been proposed as a promising biomarker in renal injury. This study aimed to assess serum and urinary BMP-7 levels in pediatric obstructive uropathy and to evaluate its potential diagnostic and prognostic significance.

This prospective observational study enrolled 200 pediatric patients with obstructive uropathy (including UPJO, UVJO, and PUV) and 200 healthy controls. Serum and urinary BMP-7 levels were measured before and three months after surgery using a human BMP-7 ELISA kit (Zellbio). Comparisons were made between groups and between pre- and postoperative measurements using appropriate statistical analyses.

Urinary BMP-7 levels were marginally higher and serum BMP-7 levels slightly lower in patients than in controls; however, these differences were not statistically significant (P > 0.05). Postoperative evaluations revealed a minor decrease in urinary BMP-7 and a mild increase in serum BMP-7, but again without statistical significance. No significant variations were found among obstruction subtypes (UPJO, UVJO, PUV).

While BMP-7 plays a recognized role in renal repair in experimental models, its clinical diagnostic and prognostic utility in pediatric obstructive uropathy appears limited. Future research incorporating additional biomarkers and longer follow-up may further elucidate BMP-7's potential in predicting renal recovery and fibrosis modulation.