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Decreased urinary epidermal growth factor in children with acute renal failure: epidermal growth factor/creatinine
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China.
Insights
Urinary epidermal growth factor (EGF) excretion patterns in children with acute renal failure (ARF) were studied. EGF/Cr ratio is unreliable in ARF; urinary EGF concentration better predicts total excretion, suggesting EGF
Area of Science:
- Pediatric Nephrology
- Biochemistry
- Growth Factor Research
Background:
- Epidermal Growth Factor (EGF) plays a role in cell growth and differentiation.
- Understanding EGF excretion is crucial for assessing renal function in children.
- Animal studies suggest EGF's involvement in renal development, necessitating human verification.
Purpose of the Study:
- To investigate urinary EGF excretion patterns in healthy children and those with acute renal failure (ARF).
- To determine the reliability of EGF/Creatinine ratio versus total urinary EGF in ARF.
- To explore the potential role of EGF in pediatric renal growth and maturation.
Main Methods:
- Collected random and 24-hour urine samples from children.
- Measured urinary Epidermal Growth Factor (EGF) and Creatinine concentrations.
- Analyzed EGF/Creatinine ratios and daily total urinary EGF excretion.
- Correlated urinary EGF levels with serum creatinine during ARF recovery.
Main Results:
- Urinary EGF/Creatinine ratio peaked in children aged 1 month to 3 years.
- A significant correlation existed between random and 24-hour urine EGF/Creatinine ratios.
- Urinary EGF/Creatinine declined during ARF but rose with creatinine normalization; total EGF excretion showed different trends.
- Serum EGF levels remained stable throughout ARF.
Conclusions:
- EGF may be involved in renal growth/maturation in early childhood.
- Urinary EGF likely originates from the kidneys.
- Urinary EGF excretion is decreased in children with ARF.
- Urinary EGF concentration, not EGF/Creatinine ratio, is a better predictor of total EGF excretion in ARF.
Abstract:
To verify some animal experimental results in humans, we have studied urinary epidermal growth factor (EGF) excretion in normal children as well as children with acute renal failure (ARF). Urinary EGF excretion was expressed as a ratio of urinary EGF to urinary creatinine concentration (EGF/Cr) for random and 24-h urine, and a daily total urinary EGF for 24-h urine. The highest urinary EGF/Cr in children was found at 1 mo to 3 y of age. There was a highly significant correlation between random urine EGF/Cr and 24-h urine EGF/Cr (r = 0.92, p < 0.001), whereas no correlation of urinary EGF/Cr with daily total urine EGF was found. During the course of ARF, a decline in urinary EGF/Cr from the period before peak serum creatinine to the period after the declination of serum creatinine was noted (p = 0.013, n = 13, by repeated measure analysis), with a constant low daily total urine EGF (p value not significant). However, a rise in both urinary EGF/Cr and daily total urine EGF was found between the period of serum creatinine decline and the period of completely normal serum creatinine (p < 0.001). Serum EGF remained unchanged throughout the course of ARF. These results suggest 1) the possible role of EGF in renal growth or maturation during the first 2 or 3 y of life, 2) the possible renal origin of human urinary EGF, and 3) decreased urinary EGF excretion in children with ARF. In particular, EGF/Cr is not a reliable indicator for the expression of actual urinary EGF excretion in ARF. Instead of urinary EGF/Cr, urinary EGF concentration may be used to predict the daily total urinary EGF excretion during ARF. These results provide the pattern of urinary EGF excretion during ARF in children and may be of help for further clinical studies.