arginine levels in neonatal hydronephrosis

Background: fetal hydronephrosis (hn) is a prevalent condition detected in prenatal ultrasounds, affecting 1-5% of pregnancies. while mild cases often resolve without intervention, severe cases frequently require surgical treatment.objectives: this study investigates the association between l-arginine levels and the severity of neonatal hn, as prior research has indicated l-arginine’s crucial role in kidney function. methods: a prospective case-control study was conducted at the children's medical center in tehran from october 2021 to october 2023. neonates with hn (n = 24) were compared with healthy control neonates (n = 24). arginine levels in plasma and urine were measured using lc-ms/ms. statistical analyses included pearson correlation coefficients and receiver operating characteristic (roc) curves to assess the need for surgical intervention. results: urine arginine levels were significantly lower in the hn group compared to the controls (p = 0.03), while plasma arginine levels showed no significant difference (p = 0.82). a significant positive correlation was found between urine arginine levels in the hn and control groups [r (24) = 0.44, p < 0.05], but no significant correlations with kidney measurements or clinical outcomes were observed. thirteen patients (54.2%) required surgery, with roc analysis indicating low sensitivity (auc = 0.53, p = 0.7). conclusions: our findings suggest that urine arginine levels may be lower in neonates with hn, indicating a potential link between arginine and kidney function. however, further research is needed to validate these findings and explore the utility of arginine as a cost-effective biomarker for the early detection of kidney abnormalities in pediatric nephrology.