Low levels of urinary epidermal growth factor predict chronic kidney disease progression in children
Urinary epidermal growth factor (uEGF) has recently been identified as a promising biomarker of chronic kidney disease (CKD) progression in adults with glomerular disease. Low levels of uEGF predict CKD progression and appear to reflect the extent of tubulointerstitial damage. We investigated the re...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
20 March 2019
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| In: |
Kidney international
Year: 2019, Volume: 96, Issue: 1, Pages: 214-221 |
| ISSN: | 1523-1755 |
| DOI: | 10.1016/j.kint.2019.01.035 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1016/j.kint.2019.01.035 Verlag: http://www.sciencedirect.com/science/article/pii/S008525381930184X 
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| Author Notes: | Karolis Azukaitis, Wenjun Ju, Marietta Kirchner, Viji Nair, Michelle Smith, Zhiyin Fang, Daniela Thurn-Valsassina, Aysun Bayazit, Anna Niemirska, Nur Canpolat, Ipek Kaplan Bulut, Fatos Yalcinkaya, Dusan Paripovic, Jerome Harambat, Nilgun Cakar, Harika Alpay, Francesca Lugani, Francesca Mencarelli, Mahmut Civilibal, Hakan Erdogan, Jutta Gellermann, Enrico Vidal, Yilmaz Tabel, Charlotte Gimpel, Pelin Ertan, Onder Yavascan, Anette Melk, Uwe Querfeld, Elke Wühl, Matthias Kretzler, and Franz Schaefer ; for the 4C Study and ESCAPETrial Group: Klaus Arbeiter, Alejandra Rosales, Jiri Dusek, Ariane Zaloszyc, Uwe Querfeld, Jutta Gellermann, Max Liebau, Lutz Weber, Evelin Muschiol, Rainer Büscher, Jun Oh, Anette Melk, Daniela Thurn-Valassina, Dieter Haffner [und weitere] |
| Summary: | Urinary epidermal growth factor (uEGF) has recently been identified as a promising biomarker of chronic kidney disease (CKD) progression in adults with glomerular disease. Low levels of uEGF predict CKD progression and appear to reflect the extent of tubulointerstitial damage. We investigated the relevance of uEGF in pediatric CKD. We performed a post hoc analysis of the Cardiovascular Comorbidity in Children with CKD (4C) study, which prospectively follows children aged 6-17 years with baseline estimated glomerular filtration rate (eGFR) of 10-60 ml/min/1.73 m2. uEGF levels were measured in archived urine collected within 6 months of enrollment. Congenital abnormalities of the kidney and urinary tract were the most common cause of CKD, with glomerular diseases accounting for <10% of cases. Median eGFR at baseline was 28 ml/min/1.73 m2, and 288 of 623 participants (46.3%) reached the composite endpoint of CKD progression (50% eGFR loss, eGFR < 10 ml/min/1.73 m2, or initiation of renal replacement therapy). In a Cox proportional hazards model, higher uEGF/Cr was associated with a decreased risk of CKD progression (HR 0.76; 95% CI 0.69-0.84) independent of age, sex, baseline eGFR, primary kidney disease, proteinuria, and systolic blood pressure. The addition of uEGF/Cr to a model containing these variables resulted in a significant improvement in C-statistics, indicating better prediction of the 1-, 2- and 3-year risk of CKD progression. External validation in a prospective cohort of 222 children with CKD demonstrated comparable results. Thus, uEGF may be a useful biomarker to predict CKD progression in children with CKD. |
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| Item Description: | Published online 20 March 2019 Gesehen am 30.10.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1523-1755 |
| DOI: | 10.1016/j.kint.2019.01.035 |