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Urinary excretion of epidermal growth factor in children with reflux nephropathy
1Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Insights
Urinary epidermal growth factor (uEGF) levels decrease with age in healthy children. Low uEGF in children with reflux nephropathy may indicate reduced kidney function, suggesting its use in monitoring nephron mass.
Area of Science:
- Pediatric Nephrology
- Biomarker Discovery
- Renal Function Assessment
Background:
- Reflux nephropathy is a significant cause of kidney damage in children.
- Assessing functional nephron mass is crucial for managing pediatric kidney disease.
- Urinary epidermal growth factor (uEGF) is a potential biomarker for kidney health.
Purpose of the Study:
- To determine urinary epidermal growth factor (uEGF) levels in children with reflux nephropathy.
- To evaluate the clinical significance of uEGF as a marker for kidney function in this population.
Main Methods:
- Sandwich enzyme immunoassay was used to measure uEGF in spot urine samples from 100 children with reflux nephropathy and 100 healthy controls (ages 3-15).
- Serum creatinine, urinary alpha-1-microglobulin, and urinary microalbumin levels were also measured.
- Kidney function was assessed using 99mtechnetium dimercaptosuccinic acid (DMSA) uptake.
Main Results:
- Healthy children showed a gradual decrease in uEGF levels with increasing age.
- Significantly lower uEGF levels were observed in children with reflux nephropathy, particularly those with impaired DMSA uptake (45% with unilateral and 95% with bilateral impairment).
- uEGF levels strongly correlated with serum creatinine, urinary alpha-1-microglobulin, urinary microalbumin, and total DMSA uptake.
Conclusions:
- Urinary epidermal growth factor (uEGF) levels are reduced in children with reflux nephropathy.
- uEGF shows significant correlation with established markers of kidney damage and function.
- uEGF may serve as a valuable, non-invasive clinical tool for monitoring functional nephron mass in pediatric reflux nephropathy.
Purpose:
We determined urinary levels of epidermal growth factor in children with reflux nephropathy to evaluate the clinical significance of urinary epidermal growth factor.
Materials And Methods:
We studied 59 boys and 41 girls 3 to 15 years old with reflux nephropathy, and 64 boys and 36 girls 3 to 15 years old who were healthy. Levels of urinary epidermal growth factor were determined by sandwich enzyme immunoassay using spot urine samples. We also determined the levels of serum creatinine, urinary alpha 1-microglobulin and urinary microalbumin. Absolute values of function of the left and right kidneys were assessed by 99mtechnetium dimercapto-succinic acid (DMSA) uptake.
Results:
Levels of urinary epidermal growth factor gradually decreased with age in healthy children. There were low levels of urinary epidermal growth factor in 20 of the 44 patients (45%) with unilateral low DMSA uptake and 18 of the 19 (95%) with low total DMSA uptake (right and left uptakes). Urinary epidermal growth factor significantly correlated with serum creatinine (R = -0.702, p < 0.0001), urinary alpha 1-microglobulin (R = -0.606, p < 0.0001), urinary microalbumin (R = -0.708, p < 0.0001) and total DMSA uptake (R = 0.744, p < 0.0001).
Conclusions:
These results suggest that urinary epidermal growth factor may be a useful clinical tool to monitor functional nephron mass in children with reflux nephropathy.