Given the recently published UTI guidelines in our journal, VCUGs, while no longer automatic, still have their place when indicated as per the recommended guidelines. Even if recommended, many VCUGs may still be normal studies and the search continues for a less invasive but sensitive and specific way to determine if high grade reflux is present in a young patient. That is where proteomic analysis comes into play. What are urinary proteomes? They are patterns or expressions of urinary protein excretion that vary depending on the disease or stressor affecting the kidney.
To see if severe reflux has identifiable proteome profile Drube et al. (doi: 10.1542/peds.2010-3467) performed a case-control study of a specific urinary proteome pattern. The pattern differences reveal that the grade IV or V reflux pattern has a high level of sensitivity and specificity and may be the pilot information needed to move ahead with prospective validation in a much larger sample. We opted to publish this study despite its small sample size because the results are statistically significant and may pave the way for future studies to use proteomics to identify disease pathology without the need for more invasive diagnostic studies.
To learn more about proteomics as used to help diagnose reflux, go with the flow and give this article your attention.
