Biomarkers of fibroplastic changes in the kidney in unilateral ureteral obstruction

Objective. Evaluation of the dynamics of blood serum markers of fibroplastic transformation of the kidney in unilateral ureteral obstruction.

Material and methods. The study was approved by the local ethics committee of Yaroslavl State Medical University. A prospective comparative study was conducted, which included 33 patients with urolithiasis and unilateral ureteral obstruction caused by a stone less than 7 mm, and 15 healthy volunteers. The concentration of profibrotic cytokines TGF-β1 and CTGF was determined by ELISA. Diagnostics was performed using ultrasound and plain urography.

Results. In patients with ureteral obstruction, serum TGF-β1 (264±16.9 ng/ml) and CTGF (1141±33.1 ng/ml) concentrations at admission were significantly higher (p<0.001) than in the control group (TGF-β1 – 33±6.9 ng/ml, CTGF – 216.3±56.9 ng/ml). After 1 week, a sharp increase in TGF-β1 (18,239±556 ng/ml) and CTGF (45,765±123 ng/ml) levels was observed, indicating the development of severe fibrosis. After 1 month, blood cytokine concentrations decreased but remained above control values. Complete normalization of TGF-β1 (45±5.2 ng/ml) and CTGF (177±11.9 ng/ml) levels was observed only 2 months after obstruction elimination. In patients with prolonged obstruction (3–7 days), cytokine levels were significantly higher (p=0.03), indicating more pronounced fibrosis formation.

Conclusion. Unilateral ureteral obstruction leads to a significant increase in plasma TGF-β1 and CTGF levels, indicating the development of renal tissue fibrosis. The duration of obstruction affects the degree of fibrosis, emphasizing the need for early intervention and the promise of antifibrotic therapy.