{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:22:27Z","timestamp":1787772147772,"version":"build-2784847793"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n The urinary biomarker response precedes the appearance of any renal structural or functional derangement. Transforming growth factor-\u03b21 (TGF-\u03b21), neutrophil gelatinase associated lipocalin (NGAL), and Cystatin C (CysC) can act as the early prognostic markers in posterior urethral valve (PUV) patients.<\/jats:p>\n <\/jats:sec>\n \n Aim:<\/jats:title>\n To compare the urinary levels of TGF-\u03b21, NGAL, and CysC between PUV cases and age matched controls and to correlate these with renal structural and functional parameters.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n This prospective study included children with PUV diagnosed using the standard investigations and an equal number of age-matched controls with nonurological problems. For the study subjects, the urinary samples were collected at three different time points (pre- and postoperatively at 3 and 6 months), whereas for controls, only single-voided samples were studied. The urinary levels of TGF-\u03b21, NGAL, and CysC were estimated by the standardized techniques using the ELISA kits. Statistical methods were used to drive the comparisons between cases and controls.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Fifteen children with a median age of 10 (5\u201348) months were enrolled in each of the two groups. The mean uTGF-\u03b21 in the case group was significantly higher at all three time points (43.20 \u00b1 6.13 pg\/ml, 43.33 \u00b1 11.89 pg\/ml and 40.71 \u00b1 9.01 pg\/ml) as compared to the control group (29.12 \u00b1 8.31 pg\/ml) (\n P<\/jats:italic>\n \u2264 0.001). The median uNGAL in the case group was also higher (17.78 ng\/ml, 2.35 ng\/ml and 2.536 ng\/ml) as compared to the control group (1.31 ng\/ml). However, the difference was significant only preoperatively (\n P<\/jats:italic>\n = 0.02). The median uCysC in case group was similarly higher (0.347 \u03bcg\/ml, 0.439 \u03bcg\/ml, and 0.382 \u03bcg\/ml) than the control group (0.243 \u03bcg\/ml) (\n P<\/jats:italic>\n > 0.05). Serum creatinine in the case group (0.49 mg\/dl) showed no significant rise above that of control (0.24 mg\/dl). A cutoff value of uTGF-\u03b21 = 36.55 pg\/ml (\n P<\/jats:italic>\n < 0.001), uNGAL = 0.879 ng\/ml (\n P<\/jats:italic>\n = 0.02), and uCysC = 0.25 \u03bcg\/ml (\n P<\/jats:italic>\n = 0.22) was found to be associated with renal damage in PUV. A significant correlation was found between uNGAL and S. creatinine at 3 months (\n r<\/jats:italic>\n = 0.43,\n P<\/jats:italic>\n = 0.017) and 6 months (\n r<\/jats:italic>\n = 0.47,\n P<\/jats:italic>\n = 0.08).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The elevated uTGF-\u03b21, a decline in uNGAL and an increase in uCysC suggests ongoing inflammation, improvement in hydronephrosis and a prolonged proximal tubular dysfunction in PUV patients, respectively.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_210_23","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T15:00:34Z","timestamp":1715180434000},"page":"204-212","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Role of Urinary Biomarkers (Transforming Growth Factor \u03b21, Neutrophil Gelatinase-Associated Lipocalin, and Cystatin C) as a Prognostic Factor of Renal Outcome in the Posterior Urethral Valve"],"prefix":"10.4103","volume":"29","author":[{"given":"Nitesh Kumar","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasanka Shekhar","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India"},{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simmi K.","family":"Ratan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujoy","family":"Neogi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binita","family":"Goswami","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Maulana Azad Medical College, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"key":"R1-20240905","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s12894-018-0364-1","article-title":"Posterior urethral valves:10 years audit of epidemiologic, diagnostic and therapeutic aspects in Yaound\u00e9gynaeco-obstetric and paediatric hospital","volume":"18","author":"Tambo","year":"2018","journal-title":"BMC Urol"},{"key":"R2-20240905","doi-asserted-by":"crossref","first-page":"31","DOI":"10.37224\/JP.2020.9192.05","article-title":"Prognostic biomarkers and factors in posterior urethral valves","volume":"23","author":"Luchi\u0163a","year":"2020","journal-title":"JP"},{"key":"R3-20240905","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/jiaps.JIAPS_148_18","article-title":"Consensus on the management of posterior urethral valves from antenatal period to puberty","volume":"24","author":"Sharma","year":"2019","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R4-20240905","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1007\/s12098-021-03721-9","article-title":"Renal biopsy in children-effect on treatment decisions:A single-center experience","volume":"88","author":"Pilania","year":"2021","journal-title":"Indian J Pediatr"},{"key":"R5-20240905","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1038\/ki.2011.198","article-title":"Biomarkers in chronic kidney disease:A review","volume":"80","author":"Fassett","year":"2011","journal-title":"Kidney Int"},{"key":"R6-20240905","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1007\/s00467-020-04877-w","article-title":"Promising biomarkers in pediatric chronic kidney disease through the kaleidoscope of CAKUT background complexity","volume":"36","author":"Stankovic","year":"2021","journal-title":"Pediatr Nephrol"},{"key":"R7-20240905","doi-asserted-by":"crossref","first-page":"174510","DOI":"10.1016\/j.ejphar.2021.174510","article-title":"TGF-\u03b2-induced fibrosis:A review on the underlying mechanism and potential therapeutic strategies","volume":"911","author":"Ong","year":"2021","journal-title":"Eur J Pharmacol"},{"key":"R8-20240905","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1002\/path.5680","article-title":"TGF-\u03b2 as a driver of fibrosis:Physiological roles and therapeutic opportunities","volume":"254","author":"Budi","year":"2021","journal-title":"J Pathol"},{"key":"R9-20240905","doi-asserted-by":"crossref","first-page":"112002","DOI":"10.1016\/j.biopha.2021.112002","article-title":"Lipocalin-2:Structure, function, distribution and role in metabolic disorders","volume":"142","author":"Jaberi","year":"2021","journal-title":"Biomed Pharmacother"},{"key":"R10-20240905","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1007\/s00467-020-04602-7","article-title":"Longitudinal kidney injury biomarker trajectories in children with obstructive uropathy","volume":"35","author":"McLeod","year":"2020","journal-title":"Pediatr Nephrol"},{"key":"R11-20240905","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1007\/s00467-012-2217-6","article-title":"Urinary NGAL, cystatin C, \u03b22-microglobulin, and osteopontin significance in hydronephrotic children","volume":"27","author":"Madsen","year":"2012","journal-title":"Pediatr Nephrol"},{"key":"R12-20240905","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s00467-019-04349-w","article-title":"The role of urinary NGAL and serum cystatin C in assessing the severity of ureteropelvic junction obstruction in infants","volume":"35","author":"Pavlaki","year":"2020","journal-title":"Pediatr Nephrol"},{"key":"R13-20240905","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1177\/2051415820947561","article-title":"Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker of renal injury in patients with ureteric stones:A pilot study","volume":"14","author":"Bolgeri","year":"2021","journal-title":"J Clin Urol"},{"key":"R14-20240905","doi-asserted-by":"crossref","first-page":"e0269436","DOI":"10.1371\/journal.pone.0269436","article-title":"Cystatin C proteoforms in chronic kidney disease","volume":"18","author":"Dahl","year":"2023","journal-title":"PLoS One"},{"key":"R15-20240905","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1097\/ALN.0b013e3181cded3f","article-title":"Biomarkers of acute kidney injury:An evolving domain","volume":"112","author":"McIlroy","year":"2010","journal-title":"Anesthesiology"},{"key":"R16-20240905","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1590\/2175-8239-jbn-2019-0240","article-title":"Cystatin C:Not just a marker of kidney function","volume":"42","author":"Fernando","year":"2020","journal-title":"J Bras Nefrol"},{"key":"R17-20240905","doi-asserted-by":"crossref","first-page":"41012","DOI":"10.1038\/srep41012","article-title":"Predictive value of serum cystatin C for acute kidney injury in adults:A meta-analysis of prospective cohort trials","volume":"7","author":"Yong","year":"2017","journal-title":"Sci Rep"},{"key":"R18-20240905","doi-asserted-by":"crossref","first-page":"173","DOI":"10.2298\/MPNS1506173C","article-title":"Cystatin C \u2013More than the marker of the glomerular filtration rate","volume":"68","author":"\u010cabarkapa","year":"2015","journal-title":"Med Pregl"},{"key":"R19-20240905","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.urology.2015.09.007","article-title":"Urinary IP-10, MCP-1, NGAL, Cystatin-C, and KIM-1 levels in prenatally diagnosed unilateral hydronephrosis:The search for an ideal biomarker","volume":"87","author":"Karakus","year":"2016","journal-title":"Urology"},{"key":"R20-20240905","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S0090-4295(00)00591-4","article-title":"Increased urinary transforming growth factor-beta (1) excretion in children with posterior urethral valves","volume":"56","author":"MacRae Dell","year":"2000","journal-title":"Urology"},{"key":"R21-20240905","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1681\/ASN.2011040325","article-title":"Test characteristics of urinary biomarkers depend on quantitation method in acute kidney injury","volume":"23","author":"Ralib","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"R22-20240905","doi-asserted-by":"crossref","first-page":"219","DOI":"10.4103\/jiaps.JIAPS_104_19","article-title":"Role of urinary transforming growth factor beta-B1 and monocyte chemotactic protein-1 as prognostic biomarkers in posterior urethral valve","volume":"25","author":"Panigrahi","year":"2020","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"R23-20240905","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1007\/s00467-013-2506-8","article-title":"The role of urinary TGF-\u03b2\u2081, TNF-\u03b1, IL-6 and microalbuminuria for monitoring therapy in posterior urethral valves","volume":"28","author":"Mandelia","year":"2013","journal-title":"Pediatr Nephrol"},{"key":"R24-20240905","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.2215\/CJN.09640911","article-title":"Urinary biomarkers in obstructive nephropathy","volume":"7","author":"Trnka","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R25-20240905","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.urology.2013.07.058","article-title":"Did antenatal diagnosis protect against chronic kidney disease in patients with posterior urethral valves? A multicenter study","volume":"82","author":"Sarhan","year":"2013","journal-title":"Urology"},{"key":"R26-20240905","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jpedsurg.2018.10.091","article-title":"Current epidemiology and antenatal presentation of posterior urethral valves:Outcome of BAPS CASS national audit","volume":"54","author":"Brownlee","year":"2019","journal-title":"J Pediatr Surg"},{"key":"R27-20240905","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12301-021-00238-7","article-title":"Antenatal and postnatal management of posterior urethral valves:Where do we stand?","volume":"27","author":"Abdelhalim","year":"2021","journal-title":"Afr J Urol"},{"key":"R28-20240905","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1093\/clinchem\/43.6.913","article-title":"The search continues \u2013An ideal marker of GFR","volume":"43","author":"Swan","year":"1997","journal-title":"Clin Chem"},{"key":"R29-20240905","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1373\/clinchem.2010.144261","article-title":"Serum creatinine and glomerular filtration rate:Perception and reality","volume":"56","author":"Dalton","year":"2010","journal-title":"Clin Chem"},{"key":"R30-20240905","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jpurol.2009.05.016","article-title":"Prognostic value of serum creatinine levels in children with posterior urethral valves treated by primary valve ablation","volume":"6","author":"Sarhan","year":"2010","journal-title":"J Pediatr Urol"},{"key":"R32-20240905","first-page":"373","article-title":"Evaluation of urinary neutrophil gelatinase-associated lipocalin as a biomarker in pediatric vesicoureteral reflux assessment","volume":"14","author":"Amiri","year":"2020","journal-title":"Iran J Kidney Dis"},{"key":"R33-20240905","doi-asserted-by":"crossref","first-page":"242.e1","DOI":"10.1016\/j.jpurol.2019.03.009","article-title":"The role of renal biomarkers to predict the need of surgery in congenital urinary tract obstruction in infants","volume":"15","author":"Kostic","year":"2019","journal-title":"J Pediatr Urol"},{"key":"R34-20240905","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1515\/CCLM.2006.050","article-title":"Urinary cystatin C as a specific marker of tubular dysfunction","volume":"44","author":"Conti","year":"2006","journal-title":"Clin Chem Lab Med"},{"key":"R35-20240905","doi-asserted-by":"crossref","first-page":"904452","DOI":"10.3389\/fruro.2022.904452","article-title":"Posterior urethral valve in children:Using novel biomarkers as an early predictive tool for the onset and progression of chronic kidney disease","volume":"2","author":"Uwaezuoke","year":"2022","journal-title":"Front Urol"},{"key":"R36-20240905","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00467-019-4195-4","article-title":"First-year profile of biomarkers for early detection of renal injury in infants with congenital urinary tract obstruction","volume":"34","author":"Kostic","year":"2019","journal-title":"Pediatr Nephrol"}],"container-title":["Journal of Indian Association of Pediatric Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_210_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:31:18Z","timestamp":1787769078000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jiaps.jiaps_210_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jiaps.jiaps_210_23","relation":{},"ISSN":["0971-9261","1998-3891"],"issn-type":[{"value":"0971-9261","type":"print"},{"value":"1998-3891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2023-10-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}