For a study, researchers sought to determine if IP-10 (interferon gamma-induced protein 10), MCP-1 (monocyte chemotactic protein-1), NGAL (neutrophil gelatinase-associated lipocalin), CA (carbohydrate antigen 19–9), and KIM-1 (kidney injury molecule-1) could detect the need for pyeloplasty in antenatally diagnosed unilateral hydronephrosis in the presence of SnDRF in antenatally diagnosed unilateral hydronephrosis. The study relied on a database of prospectively collected urine biomarkers. In the Antenatal Hydronephrosis (AH) group, there were a total of 53 patients. In addition, 19 children were used as controls, all of whom had no history of AH and normal urinary ultrasonography. Patients having an initial ipsilateral DRF (Differential Renal Function) of more than 50% were classified as supranormal differential renal function (SnDRF), while the rest were classified as non-SnDRF. In both groups, patients who did not have surgery were characterized as having non-obstructive dilation (NOD). Pyeloplasty was performed in 6/20 of the SnDRF patients and 19/33 of the non-SnDRF patients. The presence or absence of SnDRF had no effect on biomarker levels in the pyeloplasty and NOD groups (p=1.00 for both). Urinary NGAL and CA 19–9 had 83% and 100% sensitivity, 86% and 79% specificity, respectively, in determining the need for surgery in the SnDRF group, whereas urinary IP-10 and KIM-1 had 84% and 83% sensitivity, 57% and 71% specificity, respectively. In SnDRF groups, urinary MCP-1 could distinguish patients who had surgery with 83% sensitivity and 50% specificity. The presence of SnDRF in the kidney did not affect biomarker levels, according to the results. Furthermore, NGAL and CA 19–9 appeared to better predict the need for surgical correction in patients with SnDRF before renal function deteriorates.