{"doi":"10.1371/journal.pone.0270018","title":"Association between urinary biomarkers MMP-7/TIMP-2 and reduced renal function in children with ureteropelvic junction obstruction","abstract":"IMPORTANCE: Extracellular matrix proteins and enzymes involved in degradation have been found to be associated with tissue fibrosis and ureteropelvic junction obstruction (UPJO). In this study we developed a promising urinary biomarker model which can identify reduced renal function in UPJ obstruction patients. This can potentially serve as a non-invasive way to enhance surgical decision making for patients and urologists. OBJECTIVE: We sought to develop a predictive model to identify UPJO patients at risk for reduced renal function. DESIGN: Prospective cohort study. SETTING: Pre-operative urine samples were collected in a prospectively enrolled UPJO biomarker registry at our institution. Urinary MMP-2, MMP-7, TIMP-2, and NGAL were measured as well as clinical characteristics including hydronephrosis grade, differential renal function, t1/2, and UPJO etiology. PARTICIPANTS: Children who underwent pyeloplasty for UPJO. MAIN OUTCOME MEASUREMENT: Primary outcome was reduced renal function defined as MAG3 function <40%. Multivariable logistic regression was applied to identify the independent predictive biomarkers in the original Training cohort. Model validation and generalizability were evaluated in a new UPJO Testing cohort. RESULTS: We included 71 patients with UPJO in the original training cohort and 39 in the validation cohort. Median age was 3.3 years (70% male). By univariate analysis, reduced renal function was associated with higher MMP-2 (p = 0.064), MMP-7 (p = 0.047), NGAL (p = 0.001), and lower TIMP-2 (p = 0.033). Combining MMP-7 with TIMP-2, the multivariable logistic regression model predicted reduced renal function with good performance (AUC = 0.830; 95% CI: 0.722-0.938). The independent testing dataset validated the results with good predictive performance (AUC = 0.738). CONCLUSIONS AND RELEVANCE: Combination of urinary MMP-7 and TIMP-2 can identify reduced renal function in UPJO patients. With the high sensitivity cutoffs, patients can be categorized into high risk (aggressive management) versus lower risk (observation).","journal":"PLoS ONE","year":2022,"id":265183,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":923770,"name":"Patricia S. Cho","orcid":"0000-0002-9942-6639","position":1,"is_corresponding":false},{"id":923771,"name":"Hui Zhi","orcid":"0000-0001-9103-8642","position":2,"is_corresponding":false},{"id":770950,"name":"Stephen A. Kostel","orcid":null,"position":3,"is_corresponding":false},{"id":440897,"name":"Shannon E. DiMartino","orcid":null,"position":4,"is_corresponding":false},{"id":924289,"name":"Adelle Dagher","orcid":null,"position":5,"is_corresponding":false},{"id":924290,"name":"Kylie H. Davis","orcid":null,"position":6,"is_corresponding":false},{"id":924291,"name":"Lily D. Cabour","orcid":null,"position":7,"is_corresponding":false},{"id":924292,"name":"Ashley Shimmel","orcid":null,"position":8,"is_corresponding":false},{"id":923772,"name":"James Lee","orcid":"0000-0002-8551-0258","position":9,"is_corresponding":false},{"id":439970,"name":"John W. Froehlich","orcid":"0000-0002-5354-5632","position":10,"is_corresponding":false},{"id":412144,"name":"David Zurakowski","orcid":"0000-0003-3610-6942","position":11,"is_corresponding":false},{"id":275435,"name":"Marsha A. Moses","orcid":"0000-0003-3108-0704","position":12,"is_corresponding":false},{"id":439971,"name":"Richard S. Lee","orcid":"0000-0001-9424-7175","position":13,"is_corresponding":false},{"id":924288,"name":"Hsin-Hsiao S. Wang","orcid":null,"position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T00:26:45.905331Z","pmid":"35834547","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}