Urinary Proteome Analysis at 5-Year Followup of Patients With Nonoperated Ureteropelvic Junction Obstruction Suggests Ongoing Kidney Remodeling.

Abstract

Purpose: Severe ureteropelvic junction obstruction is treated surgically. However,
for milder cases most clinical teams adopt a watchful waiting approach and
only operate in the presence of significant decline of renal function combined with
severe hydronephrosis. Little is known about the long-term consequences of
ureteropelvic junction obstruction.
Materials and Methods: Using capillary electrophoresis coupled with mass spectrometry,
we analyzed the urinary proteome of 42 patients with ureteropelvic
junction obstruction 5 years postoperatively or 5 years following spontaneous
resolution.
Results: At 5-year followup urinary proteomes were similar between patients
with early surgical correction of ureteropelvic junction obstruction and age
matched controls. In contrast, urinary proteomes differed significantly between
conservatively followed patients and controls. Analyses of the proteomic differences
suggested ongoing renal or ureteral remodeling in the conservatively followed
patients that was not visible clinically.
Conclusions: Long-term followup studies are warranted in patients with ureteropelvic
junction obstruction, especially those followed conservatively, to determine
whether the observed changes in the urinary proteomes become clinically
relevant at a later stage.