Related Experiment Video
Updated: Jun 16, 2026
Identification of the Source of Secreted Proteins in the Kidney by Brefeldin A Injection
Published on: November 10, 2021
Levels of urinary transforming growth factor beta-1 in children with D+ hemolytic uremic syndrome
María Gracia Caletti1, Alejandro Balestracci, Adriana Haydeé Roy
1Department of Nephrology, Prof. Dr. Juan P. Garrahan Children's Hospital, Combate de los Pozos 1881, 1245 Buenos Aires, Argentina. mcaletti@garrahan.gov.ar
Insights
Survivors of postdiarrheal hemolytic uremic syndrome (D+ HUS) may develop chronic kidney disease. Elevated urinary transforming growth factor beta-1 (TGFbeta-1) may indicate early kidney damage in D+ HUS patients.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Renal Medicine
Background:
- Postdiarrheal hemolytic uremic syndrome (D+ HUS) survivors have a high risk of developing chronic kidney disease.
- Transforming growth factor beta-1 (TGFbeta-1) is a key fibrogenic factor implicated in chronic nephropathies.
Purpose of the Study:
- To investigate if urinary TGFbeta-1 levels can serve as an early marker for kidney damage in D+ HUS survivors without apparent renal disease.
- To compare TGFbeta-1 excretion in D+ HUS patients and healthy controls.
Main Methods:
- Urine samples were collected from 39 D+ HUS survivors and 18 healthy controls (HC).
- Urinary TGFbeta-1 levels were measured and normalized to creatinine.
- Statistical analysis was performed to compare TGFbeta-1 levels between groups and identify correlations.
Main Results:
- Urinary TGFbeta-1 excretion was significantly higher in D+ HUS patients (median 73 pg/mg creatinine) compared to HC (median 28 pg/mg creatinine) (p < 0.001).
- No significant correlation was found between TGFbeta-1 excretion and age, white blood cell count, oligoanuric period, peak creatinine, or follow-up duration.
- Elevated TGFbeta-1 suggests potential ongoing renal tissue damage.
Conclusions:
- Increased urinary TGFbeta-1 may be an early indicator of subclinical renal damage in D+ HUS survivors.
- Lifelong follow-up is recommended for D+ HUS survivors, even those who appear to have recovered.
- Further monitoring is needed to establish the clinical utility of urinary TGFbeta-1 for predicting long-term outcomes.
Abstract:
About 25-50% of survivors of the acute phase of postdiarrheal hemolytic uremic syndrome (D+ HUS) develop chronic renal disease. Transforming growth factor beta-1 (TGFbeta-1) is the main fibrogenic growth factor in humans, and there is a significant correlation between its levels and the grade of interstitial fibrosis in chronic nephropathies. We hypothesized that increased urinary TGFbeta-1 may be an early indicator of sequelae in D+ HUS patients who show no sign of renal damage as determined by conventional diagnostic tests. We therefore compared the levels of TGFbeta-1 in urine collected from healthy controls (HC) (n = 18) with that from patients with a past history of D+ HUS (n = 39). We found that TGFbeta-1 excretion was significantly higher (p < 0.001) in the patient group (median level 73 pg/mg creatinine) than in the HC (median level 28 pg/mg creatinine). TGFbeta-1 excretion did not correlate with age, white blood cell count, length of oligoanuric period, maximum creatinine at the acute stage, or length of the follow-up. Since TGFbeta-1 excretion may reflect ongoing renal tissue damage, our results emphasize the need for the lifelong follow-up of patients with a past history of D+ HUS, even those showing apparent recovery. Long-term monitoring of this cohort is necessary to determine the clinical utility of our findings.
Related Concept Videos
01:24Serum Studies: Renal Function Tests
01:16TGF - β Signaling Pathway