Urine metabolome investigation in pediatric urology. Review

Metabolomics is the science of studying small molecules (50–5,000 Da) formed because of the implementation of metabolic pathways in cells and the maintenance of their vital functions. The study of urine metabolome is a promising direction for diagnosing early stages of damage to various cells of the urinary system in pediatric urology, allowing the study of biomarkers or their spectrum, which can improve the identification of existing disorders, and multivariate analysis will provide greater accuracy in making a diagnosis. This study aimed to summarize existing information on urine metabolome and its changes in cases of congenital malformations of the urinary system, accompanied by renal dysplasia, leading to acute kidney injury or chronic kidney disease. A literature search and review was conducted using PubMed, Embase, and Google Scholar. The review presents the possibilities of metabolomic analysis to provide a qualitatively new level of diagnosis and monitoring of damage to the structures of organs and tissues of the urinary system, identifying predictors of pathology progression, and personalized techniques for making medical decisions. However, this method is limited by the high cost of the equipment, need for training of highly qualified personnel, and difficulty in interpreting the results. The study of urine metabolome is very promising for the diagnosis and selection of a timely, rational treatment strategy for children with malformations of the urinary system.