Urinary Epidermal Growth Factor as a Marker of Disease Progression in Children With Nephrotic Syndrome.

Autor: Gipson DS; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Trachtman H; Division of Nephrology, Department of Pediatrics, New York University Langone Health, New York, New York, USA., Waldo A; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Gibson KL; University of North Carolina Kidney Center at Chapel Hill, Chapel Hill, North Carolina, USA., Eddy S; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Dell KM; Department of Pediatrics, Case Western Reserve University, Cleveland Clinic Children's, Cleveland, Ohio, USA., Srivastava T; Section of Nephrology, Children's Mercy Hospital and University of Missouri at Kansas City, Kansas City, Missouri, USA., Lemley KV; Division of Nephrology, Children's Hospital-LA, Los Angeles, California, USA., Greenbaum LA; Division of Pediatric Nephrology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Hingorani S; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.; Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA., Meyers KE; Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Kaskel FJ; Division of Nephrology, Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York, USA., Reidy KJ; Division of Nephrology, Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York, USA., Sethna CB; Pediatric Nephrology, Cohen Children's Medical Center of New York, Zucker School of Medicine, Hofstra University, Hempstead, New York, USA., Tran CL; Department of Pediatrics, Mayo Clinic, Rochester, Minnesota, USA., Wang CS; Division of Pediatric Nephrology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Tuttle KR; Providence St. Joseph Health, Providence Medical Research Center, Spokane, Washington, USA.; Department of Internal Medicine, University of Washington, Seattle, Washington, USA., Oh G; Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA., Neu AM; Division of Pediatric Nephrology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Brown E; Division of Nephrology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, USA., Lin JJ; Division of Pediatric Nephrology, Brenner Children's Hospital, Wake Forest University Baptist Health, Winston-Salem, North Carolina, USA., Yee JL; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Roth TM; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Troost JP; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Gillespie BW; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Sampson MG; Division of Nephrology, Boston Children's Hospital, Boston, Massachusetts, USA., Kretzler M; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA., Ju W; Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
Jazyk: angličtina
Zdroj: Kidney international reports [Kidney Int Rep] 2019 Dec 05; Vol. 5 (4), pp. 414-425. Date of Electronic Publication: 2019 Dec 05 (Print Publication: 2020).
DOI: 10.1016/j.ekir.2019.11.018
Abstrakt: Introduction: Childhood-onset nephrotic syndrome has a variable clinical course. Improved predictive markers of long-term outcomes in children with nephrotic syndrome are needed. This study tests the association between baseline urinary epidermal growth factor (uEGF) excretion and longitudinal kidney function in children with nephrotic syndrome.
Methods: The study evaluated 191 participants younger than 18 years enrolled in the Nephrotic Syndrome Study Network, including 118 with their first clinically indicated kidney biopsy (68 minimal change disease; 50 focal segmental glomerulosclerosis) and 73 with incident nephrotic syndrome without a biopsy. uEGF was measured at baseline for all participants and normalized by the urine creatinine (Cr) concentration. Renal epidermal growth factor (EGF) mRNA was measured in the tubular compartment microdissected from kidney biopsy cores from a subset of patients. Linear mixed models were used to test if baseline uEGF/Cr and EGF mRNA expression were associated with change in estimated glomerular filtration rate (eGFR) over time.
Results: Higher uEGF/Cr at baseline was associated with slower eGFR decline during follow-up (median follow-up = 30 months). Halving of uEGF/Cr was associated with a decrease in eGFR slope of 2.0 ml/min per 1.73 m 2 per year ( P  < 0.001) adjusted for age, race, diagnosis, baseline eGFR and proteinuria, and APOL1 genotype. In the biopsied subgroup, uEGF/Cr was correlated with EGF mRNA expression ( r  = 0.74; P  < 0.001), but uEGF/Cr was retained over mRNA expression as the stronger predictor of eGFR slope after multivariable adjustment (decrease in eGFR slope of 1.7 ml/min per 1.73 m 2 per year per log 2 decrease in uEGF/Cr; P  < 0.001).
Conclusion: uEGF/Cr may be a useful noninvasive biomarker that can assist in predicting the long-term course of kidney function in children with incident nephrotic syndrome.
(© 2019 International Society of Nephrology. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: