Is BMP-7 a promising diagnostic and prognostic biomarker for pediatric obstructive uropathy?

BACKGROUND: Obstructive uropathy remains a major contributor to pediatric chronic kidney disease. Reliable biomarkers that predict disease progression or recovery are still lacking. Bone morphogenetic protein-7 (BMP-7), known for its anti-fibrotic and renoprotective properties, has been proposed as a promising biomarker in renal injury. This study aimed to assess serum and urinary BMP-7 levels in pediatric obstructive uropathy and to evaluate its potential diagnostic and prognostic significance. METHODS: This prospective observational study enrolled 200 pediatric patients with obstructive uropathy (including UPJO, UVJO, and PUV) and 200 healthy controls. Serum and urinary BMP-7 levels were measured before and three months after surgery using a human BMP-7 ELISA kit (Zellbio). Comparisons were made between groups and between pre- and postoperative measurements using appropriate statistical analyses. RESULTS: Urinary BMP-7 levels were marginally higher and serum BMP-7 levels slightly lower in patients than in controls; however, these differences were not statistically significant (P > 0.05). Postoperative evaluations revealed a minor decrease in urinary BMP-7 and a mild increase in serum BMP-7, but again without statistical significance. No significant variations were found among obstruction subtypes (UPJO, UVJO, PUV). CONCLUSION: While BMP-7 plays a recognized role in renal repair in experimental models, its clinical diagnostic and prognostic utility in pediatric obstructive uropathy appears limited. Future research incorporating additional biomarkers and longer follow-up may further elucidate BMP-7's potential in predicting renal recovery and fibrosis modulation.