Background: Stenosis of the pelvicoureteral junction constitutes 1/3 of congenital defects of the urinary tract and is the most frequent cause of a total or partial urinary tract obstruction. The progressive reactive changes in a kidney caused by the obstacle of the urine outflow from renal pelvis are called an obstructive uropathy. Aim of the study was to examine concentration of TGF β1, CCL5/RANTES and sFas/Apo-1 in the urine of patients operated due to hydronephrosis and to compare them with the results obtained in controls.
Material and methods: The examined group consisted of 28 children, aged 1 month to 17 years (mean age — 8.5 yrs), operated on due to hydronephrosis. Bilateral hydronephrosis was diagnosed in 2 children (7.1%). Five patients (17.8%) were operated on during the first year of life. 26 patients underwent ureteropyeloplasty m/o Hynes-Anderson, and in two cases a nephrectomy was performed. The level of creatinine and concentrations of examined factors (TGF β1, CCL5/RANTES, sFas/Apo-1) were determined in the samples of urine from the bladder and renal pelvis in all patients. The reference group consisted of 25 children operated on due to the inguinal hernia.
Results: The mean TGF b1 concentration in urine from the renal pelvis (2365.491 ± 2361.748 pg/mg creatinine) was slightly higher than its concentration in urine from the bladder (2329.287 ± 2099.852 pg/mg creatinine) and both were statistically significantly higher than the concentration in the urine of patients from the reference group (971.067 ± 1426.541 pg/mg creatinine) (p < 0.05). The mean CCL5/RANTES concentration in urine from the renal pelvis (355.7143 ± 1387.583 pg/ml) was higher than its concentration in urine from the bladder (196.9643 ± 625.038 pg/ml) and was statistically significantly higher than the concentration in urine of patients from the reference group (41.2000 ± 60.627 pg/ml) (p < 0.05). The mean sFas/Apo-1 concentration in urine from the pelvis (0.637743 ± 0.308462 ng/ml) was significantly statistically higher than both its concentration in urine from the bladder (0.481149 ± 0.308462 ng/ml) and its concentration in the urine of patients from the reference group (0.379059 ± 0.156984 ng/ml) (p < 0.05).
Conclusions: Obtained results indicate, that the concentrations of TGF β 1, CCL5/RANTES and sFas/Apo-1 in the urine of pediatric patients with hydronephrosis are significantly higher than in healthy patients what is probably caused by intensified fibrosis of the renal parenchyma, by interstitial inflammatory changes, as well as by disorders of cellular apoptosis.