Evaluation of potential of urinary Matrix Metalloproteinase-7 (MMP-7) as a biomarker for decision making of pyeloplasty and therapeutic monitoring in patients with unilateral uretero-pelvic junction obstruction.

Ureteropelvic junction obstruction is a major cause of hydronephrosis in children and can result in progressive renal damage. While some patients improve with observation, others require pyeloplasty. Renal dynamic scan is the current standard for assessing obstruction and split renal function but has limitations such as radiation exposure and occasional inconclusive results. Hence a reliable non invasive biomarker is needed.

Matrix metalloproteinase 7 is associated with renal injury and fibrosis and may reflect the severity of obstruction. This prospective study will evaluate urinary MMP 7 in children up to 12 years with unilateral UPJO and correlate it with pelvis to cortex ratio, Society for Fetal Urology grade, and split renal function. Levels will be assessed before surgery and three months after intervention. The study will also determine a cut off value for predicting surgical need and compare urinary with serum MMP 7.

The findings may support the role of urinary MMP 7 in decision making and postoperative monitoring in UPJO.