Do aquaporins protect against renal damage in PUJ obstruction? (V1)
Research type
Research Study
Full title
An investigation of whether renal and lower urinary tract aquaporin expression protects kidney function from the pressure effects of pelvi-ureteric junction (PUJ) obstruction in children. Furthermore, this study aims to develop urine aquaporin measurement as a novel, non-invasive, biomarker of childhood pelvi-ureteric junction obstruction.
IRAS ID
131160
Contact name
Laura Jackson
Contact email
Research summary
Do water channels (aquaporins) in the kidney and its drainage tubes protect the kidney against high-pressure damage in childhood pelvi-ureteric junction (PUJ) obstruction? Can measurement of urine levels of aquaporins predict which children need surgery before irreversible kidney damage occurs?
One in 200 babies is diagnosed before birth with a swollen kidney (hydronephrosis). The causes are varied, and include pelvi-ureteric junction (PUJ) obstruction, where narrowing of the upper part of the tube (ureter) connecting the kidney to the bladder impedes urine drainage from the kidney.
Following birth ultrasound scans and x-ray tests are performed aiming to differentiate children requiring surgery for PUJ obstruction from those with harmless hydronephrosis which may resolve spontaneously. Often these tests do not conclusively confirm or refute the presence of damaging obstruction, and so children are monitored with repeated investigations. Sometimes the kidney becomes damaged during this period of observation.
Aquaporins are water channels produced by the kidney and its drainage system, and their levels can be measured directly in these tissues and urine. Evidence suggests kidney obstruction causes reduced aquaporin production, however when or why this occurs, and the relationship with kidney function is largely unknown.
The proposed study involves measuring urine aquaporin levels in children (age 0-15 years) with and without PUJ obstruction attending Bristol Children’s Hospital. In children undergoing surgery for PUJ obstruction, a biopsy of kidney tissue in addition to the tissue normally removed during surgery will be assessed for aquaporins.
Ultimately, we aim to demonstrate whether urinary aquaporin measurement is a useful, non-invasive test, enabling early identification and treatment of children with PUJ obstruction thus reducing the risk of kidney damage. We also aim to establish the mechanism behind changing aquaporin levels enabling future development of medicines to either protect kidney function or reduce symptoms.REC name
South West - Central Bristol Research Ethics Committee
REC reference
14/SW/1027
Date of REC Opinion
5 Sep 2014
REC opinion
Further Information Favourable Opinion