Pediatric nephrology (Berlin, Germany)
July 10, 2026 · via Europe PMC
Urothelial protein expression in pediatric patients with ureteropelvic junction obstruction.
Jackson AR, Gupta S, Kercsmar M, Froehlich JW, Lee RS, Becknell B, Ching CB.
AI summary — for doctors, generated from the abstract only
Children with ureteropelvic junction obstruction had higher urinary levels of several urothelial proteins than controls, hinting at urothelial remodeling that might serve as a biomarker.
What was studied
Pilot study of children undergoing pyeloplasty for UPJO versus healthy matched controls, measuring urothelial proteins (KRT5, KRT14, KRT20, UPK2, UPK3A) in urine by ELISA normalized to creatinine and localizing them by immunofluorescence in resected renal pelvis.
Key findings
- 23 UPJO and 14 control urines were evaluated
- KRT14/Cr, KRT20/Cr and UPK2/Cr were significantly higher in UPJO urine than in controls (p value cut off in the abstract)
- The conclusion states the proteins were also expressed locally by obstructed urothelium
Clinical relevance
Could eventually yield noninvasive markers of obstruction-related remodeling, but it is not ready for clinical use.
Who should care
Limitations
Very small pilot study; the abstract is truncated so p values and the kidney versus bladder urine comparison results are missing; no outcome linkage.
Urothelial proteins are elevated in UPJO urine, a preliminary finding needing validation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Pediatric ureteropelvic junction obstruction (UPJO) is the leading cause of congenital obstructive uropathy. Experimental models have identified local urothelial remodeling in UPJO and implicated this remodeling as a protective adaptation to preserve kidney structural integrity and function. We investigated the expression of urothelial proteins in human urine and resected tissue specimens from children with UPJO in a pilot study.
Methods
Children undergoing pyeloplasty for clinically significant UPJO and healthy age- and sex-matched controls were included. Bladder urine samples were evaluated by ELISA for urothelial proteins (KRT5, KRT14, KRT20, UPK2, UPK3A) and normalized to creatinine (Cr). When available, kidney urine collected at pyeloplasty was compared to bladder urine from the same subject. Urothelial proteins were localized by immunofluorescence microscopy in surgically resected kidney pelvises proximal to the obstruction.
Results
Twenty-three UPJO and 14 control urines were evaluated. KRT14/Cr, KRT20/Cr, and UPK2/Cr levels were significantly higher in UPJO urine compared to controls (p < 0.05; Mann-Whitney U test). Levels of urothelial proteins were as high or higher in urine obtained from the obstructed kidney when compared to paired bladder urine. Immunofluorescence microscopy of obstructed urothelium identified basal KRT14+ cells, pan-urothelial UPK+ cells, and superficial KRT20 + cells, with nuclear localization of two transcription factors implicated in obstructive urothelial remodeling, GRHL3 and PPARγ.
Conclusions
We provide evidence of increased urothelial proteins in urine from children with UPJO in this pilot study, along with evidence of their local expression by obstructed urothelium.
DOI
10.1007/s00467-026-07466-5
PMID
42429969
PMCID
PMC13672525
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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