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Objective: To investigate the urinary interferon gamma-induced protein 10 (IP-10), monocyte chemotactic protein 1 (MCP-1), neutrophil gelatinase-associated lipocalin (NGAL), cystatin-C, and kidney injury molecule-1 (KIM-1) levels in the management of children with prenatally diagnosed unilateral hydronephrosis., Materials and Methods: Twenty-seven children with antenatally diagnosed hydronephrosis were enrolled into the study. The controls consisted of 9 healthy children (6 boys, 3 girls; mean age: 41.77 ± 5.30 months). Thirteen children (9 boys, 4 girls; mean age: 48.46 ± 21.11 months) underwent pyeloplasty on follow-up; the remaining 14 (13 boys, 1 girl; mean age: 36.57 ± 14.02 months) were followed up after being diagnosed as having nonobstructive dilatation (NOD). The urinary marker levels were measured in the pyeloplasty, the NOD, and the control groups., Results: The preoperative concentrations of IP-10, MCP-1, NGAL, and KIM-1 were significantly higher in the pyeloplasty group than in the control group (P = .024, P = .002, P = .032, P = .001, respectively). The urinary IP-10 and MCP-1 levels were also significantly higher in the pyeloplasty group than in the NOD group (P = .038, P = .037, respectively). There was no significant difference between the pyeloplasty group and the NOD group regarding urinary NGAL and KIM-1. In the pyeloplasty group, urinary marker levels except cystatin-C were significantly decreased in the postoperative period., Conclusion: A decrease in levels of IP-10, MCP-1, NGAL, and KIM-1 after pyeloplasty may be used as a predictor of surgical outcome. Additionally, IP-10 and MCP-1 were superior to NGAL and KIM-1 in predicting who required surgery., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: We investigated the prognostic power of cystatin C to determine renal functional outcome in patients with prenatally diagnosed infravesical obstruction. Materials and Methods: A total of 14 fetuses with ultrasound findings of bladder outlet obstruction were enrolled in the study. Amniotic fluid and fetal urine samples were obtained. Controls consisted of 25 fetuses undergoing amniocentesis for obstetrical reasons. Three consecutive bladder punctures were performed to obtain fetal urine samples. In addition to standard prognostic parameters, cystatin C was measured in urine and amniotic fluid samples. Results: Among the study group 6 pregnancies with poor prognostic parameters were terminated and 5 fetuses died postnatally. Two of 3 fetuses with favorable urinary indices by standard prognostic parameters and relatively low cystatin C levels survived postnatally. Mean serum creatinine was 0.2 mg/dl at 1-year followup after valve ablation. Mean ± SD fetal urine levels of cystatin C were 1.44 ± 1.53 mg/l (range 0.05 to 5.62), 1.35 ± 1.43 mg/l (0.05 to 5.74) and 1.63 ± 1.46 mg/l (0.05 to 5.89) in consecutive punctures. Mean ± SD amniotic fluid cystatin C levels were 1.91 ± 0.46 mg/l (range 1.1 to 2.8) in the study group and 1.12 ± 0.20 mg/l (0.71 to 1.69) in controls (p = 0.0001). Amniotic fluid cystatin C levels were significantly higher in fetuses with suspected infravesical obstruction (study group and poor prognostic subgroup) compared to controls. There was a significant correlation between fetal urine (second and third punctures) and amniotic fluid in terms of cystatin C level (p = 0.038 and p = 0.04, respectively). Conclusions: In fetuses with prenatal ultrasound signs consistent with infravesical obstruction urinary levels of cystatin C progressively increase in consecutive samples. Amniotic fluid may represent fetal urine sample in suspected prenatal infravesical obstruction in terms of cystatin C level. Amniotic fluid cystatin C level was significantly increased in obstructed fetuses compared to normal controls. Cystatin C level in amniotic fluid sample may be sufficient to provide prognostic information in prenatally diagnosed infravesical obstruction. [Copyright &y& Elsevier]

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Purpose: We investigated the prognostic power of cystatin-c in determining renal functional outcome in patients with antenatally diagnosed infravesical obstruction (IVO). Material and Methods: A total of 10 fetuses (IVO group) with prenatal ultrasonographic findings of bladder outlet obstruction were enrolled to this study.Amniotic fluid and fetal urine samples were obtained in IVO group. Control group consisted of 25 fetuses, who have undergone amniocentesis for obstetric reasons.Three consecutive bladder punctures (48hours apart) were performed to obtain fetal urine sample. In addition to standart prognostic parameters (sodium, chloride, calcium, protein, beta-2 microglobulin, osmolarity), cystatin-c was measured both in urine and amniotic fluid samples. Results: Mean maternal age was 26.9 (22-33) years in IVO group and 28.2 (22-34) years in control group (p>0.05). In IVO group (n=10), 9 fetuses with poor prognostic parameters died either in-utero (n=4) or early postnatally (n=5). The only fetus with favorable parameters survived postnatally. His serum creatinine level was 0.2mg/dl at 1 year follow-up after valve ablation. Mean fetal urine levels of cystatin-c was 1.59±1.87, 1.39±1.76 and 1.68±1.79mg/l in serial punctures. The difference between second and third bladder punctures was significant in terms of urine cystatin-c level (p=0.015). Mean amniotic fluid cystatin-c level was 2.11±0.4mg/l in IVO group and 1.12±0.20mg/l in control group. There was a significant correlation between fetal urine (second puncture) and amniotic fluid in terms of cystatin-c level (p=0.030, r=0.717). Amniotic fluid cystatin-c level was significantly higher in fetuses with suspected infravesical obtsruction compared to control group (p<0.0001). Conclusions: Amniotic fluid may represent fetal urine sample in suspected antenatal infravesical obstruction in terms of cystatin-c level.Amniotic fluid cystatin-c level was significantly higher in obstructed fetuses compared to normal controls. Cystatin-c level in amniotic fluid sample may be sufficient to give prognostic information in antenatally diagnosed infravesical obstruction. [Copyright &y& Elsevier]

Objective: To determine the effect of antenatally detected caliectasis on the postnatal surgical intervention rate. Methods: From 2006 to 2010, 56 patients with an anteroposterior diameter (APD) of 7-20 mm on the prenatal ultrasound scan performed in the third trimester of pregnancy were included in the present study. In these 56 patients, other anomalies (vesicoureteral reflux, posterior urethral valves, duplex system, megaureter) were excluded, and the postnatal clinical and radiologic follow-up data were available. The mean follow-up was 12.82 ± 10.72 months. These 56 patients were divided into 2 groups: those with (n = 32) and without (n = 24) caliectasis. In the caliectasis group, the mean follow-up was 13.6 ± 12.09 months and was 11.7 ± 8.70 months in the group without caliectasis. The statistical correlation between the postnatal operation rates and the presence of caliectasis (APD range 7-20 mm in third trimester) was investigated using the chi-square test. Results: In the study group (n = 56) with an APD range of 7-20 mm in the third trimester, postnatal surgical treatment (pyeloplasty) was performed in 12 (37.5%) and 3 (12.5%) of the children with and without caliectasis, respectively (P = .037). The risk of postnatal surgical treatment increased threefold in patients with an APD of 7-20 mm and a diagnosis of caliectasis (relative risk 3.0, 95% confidence interval 1.07-8.40). Conclusion: In our study, the presence of concomitant caliectasis within the APD range of 7-20 mm on the third trimester ultrasound scan increased the risk of surgical treatment threefold. During prenatal counseling, the presence of caliectasis requires more rigorous follow-up. [ABSTRACT FROM AUTHOR]