Clinical and Molecular Markers of Chronic Interstitial Nephropathy in Congenital Unilateral Ureteropelvic Junction Obstruction

L. Murer, E. Benetti, S. Centi, M. Della Vella, L. Artifoni, A. Capizzi, P. Zucchetta, D. Del Prete, C. Carasi, G. Montini, W. Rigamonti, G. Zaccello

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We evaluated clinical and biological variables, and their meaning as reliable markers of chronic interstitial nephropathy in a selected group of children with prenatally detected hydronephrosis who underwent pyeloplasty because of congenital unilateral ureteropelvic junction obstruction. Materials and Methods: We reviewed the clinical, prenatal and postnatal ultrasonographic, and scintigraphic records of children for whom intraoperative biopsy records were available. We performed histological analysis, and evaluated tubulointerstitial immunostaining for vimentin and α-smooth muscle actin, and the immunohistochemical and mRNA expression of the renin-angiotensin system peptides and transforming growth factor-β1. Results: The children were divided in 2 groups according to the absence (group 1) or presence (group 2) of chronic interstitial nephropathy in the biopsy. Patients in group 2 were significantly younger at prenatal diagnosis (p = 0.031), and had decreased split renal function (p = 0.005) and worse drainage (p = 0.035) on preoperative diuretic renography. No differences were found in terms of degree of hydronephrosis, or its prenatal and postnatal variation. Group 2 biopsies exhibited greater immunostaining for α-smooth muscle actin and vimentin (p = 0.004 and p = 0.047, respectively), and transforming growth factor-β1 mRNA levels (p = 0.06). Vimentin and α-smooth muscle actin positivity correlated with renin, angiotensin II receptors 1 and 2, and transforming growth factor-β1 mRNA levels, and all correlated with preoperative split renal function and post-void washout. Conclusions: In congenital unilateral ureteropelvic junction obstruction chronic interstitial nephropathy and poor postoperative recovery seem to be associated with an earlier diagnosis of hydronephrosis, functional loss greater than 10% and worse scintigraphic drainage. Moreover, there is a strong correlation between molecular fibrogenic markers and histologically and scintigraphically demonstrated renal damage.

Original languageEnglish
Pages (from-to)2668-2673
Number of pages6
JournalJournal of Urology
Volume176
Issue number6
DOIs
Publication statusPublished - Dec 2006

Keywords

  • hydronephrosis
  • interstitial
  • nephritis
  • pediatrics
  • ureteral obstruction

ASJC Scopus subject areas

  • Urology

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