Helping children with kidney blockages get the right treatment



Professor Neil Dalton and Mr Massimo Garriboli from Evelina London Children’s Hospital and King’s College London St Thomas’ Hospital are working to find proteins in urine that will identify kidney blockages in children.

Congenital hydronephrosis affects about 1 in 500 babies, where urine gets trapped in the kidney causing it to swell.

Current diagnostics for congenital hydronephrosis are not good at predicting how the disease will progress. In many children, the problem can go away on its own or remain asymptomatic. However, for a significant number, it will continue to worsen and cause kidney failure unless treated. The condition is one of the most common causes of renal failure in children.

The researchers aim to find proteins in urine that could be used to give a more accurate prognosis. This ‘biomarker’ approach has been used successfully in other kidney diseases in recent years, including chronic kidney disease and diabetic nephropathy.

Several promising proteins have been identified as potential biomarkers for renal damage; however these have not been tested in rigorous trials.

This study is aiming to recruit 50 children who need surgery to remove a kidney blockage and compare their urine samples to 25 children without renal disease who are in hospital for routine surgery.

Neil and Massimo hope to find higher levels of the protein biomarkers in the children with kidney blockages. They can then use these results to calculate how accurate this approach could be as a test to identify hydronephrosis.

The researchers will also compare the protein biomarkers levels with the degree of kidney damage in each child. This would help to improve the accuracy of the prognosis for children diagnosed with the condition. They hope that this will prevent unnecessary surgery for those children who can be managed conservatively and avoid delaying treatment when it is needed.

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