Comparison of diagnosis of VUR nephropathy by urinary level of ceruloplasmin with DMSA-Scan in children

Background: Children with vesicoureteral reflux (VUR) are at risk of recurrent pyelonephritis, kidney scars, hypertension, and renal failure. Currently, VUR complications can be diagnosed by different imaging methods such as sonography, intravenous pyelography and dimercaptosuccinic acid (DMSA) scan, having certain limitations. Urinary level of ceruloplasmin (Cp) might be an effective non-radiological method. The aim of this study was to compare the urinary level of Cp with DMSA scan in the diagnosis of VUR complications. Methods: The present cross-sectional study was conducted in Pediatric Research Center of Qom University of Medical Sciences and Health Services, Iran. Subjects consisted of 61 children with VUR, diagnosed by voiding cystoureterography (VCUG) and undergone either DMSA scan or urine Cp measurement. VUR stages and complications of the cases were evaluated using serum and urinary renal parameters. Data were analyzed using SPSS 22. Results: Among them, 80.3% were girls with a mean age of 7.2±3.8 years. Mean Cp urine level was statistically different between VUR sides in DMSA scan (unilateral: 269.56 vs. bilateral: 450.42 µg/dL) (P=0.034, r =0.273), but was not statistically different among various VUR degrees (P=0.102, r=0.211), different ages and genders (P>0.05). Conclusions: Urinary level of Cp was not statistically different among VUR degrees, but was higher in bilateral VUR cases, indicating Cp can be used as a safe, non-invasive, and cheap measurement tool for screening test. Further studies are required to confirm Cp as an effective method.