Low levels of urinary epidermal growth factor predict chronic kidney disease progression in children
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Low levels of urinary epidermal growth factor predict chronic kidney disease progression in children. / Azukaitis, Karolis; Ju, Wenjun; Kirchner, Marietta; Nair, Viji; Smith, Michelle; Fang, Zhiyin; Thurn-Valsassina, Daniela; Bayazit, Aysun; Niemirska, Anna; Canpolat, Nur; Bulut, Ipek Kaplan; Yalcinkaya, Fatos; Paripovic, Dusan; Harambat, Jerome; Cakar, Nilgun; Alpay, Harika; Lugani, Francesca; Mencarelli, Francesca; Civilibal, Mahmut; Erdogan, Hakan; Gellermann, Jutta; Vidal, Enrico; Tabel, Yilmaz; Gimpel, Charlotte; Ertan, Pelin; Yavascan, Onder; Melk, Anette; Querfeld, Uwe; Wühl, Elke; Kretzler, Matthias; Schaefer, Franz; 4C Study; ESCAPE Trial Group.
in: KIDNEY INT, Jahrgang 96, Nr. 1, 07.2019, S. 214-221.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Low levels of urinary epidermal growth factor predict chronic kidney disease progression in children
AU - Azukaitis, Karolis
AU - Ju, Wenjun
AU - Kirchner, Marietta
AU - Nair, Viji
AU - Smith, Michelle
AU - Fang, Zhiyin
AU - Thurn-Valsassina, Daniela
AU - Bayazit, Aysun
AU - Niemirska, Anna
AU - Canpolat, Nur
AU - Bulut, Ipek Kaplan
AU - Yalcinkaya, Fatos
AU - Paripovic, Dusan
AU - Harambat, Jerome
AU - Cakar, Nilgun
AU - Alpay, Harika
AU - Lugani, Francesca
AU - Mencarelli, Francesca
AU - Civilibal, Mahmut
AU - Erdogan, Hakan
AU - Gellermann, Jutta
AU - Vidal, Enrico
AU - Tabel, Yilmaz
AU - Gimpel, Charlotte
AU - Ertan, Pelin
AU - Yavascan, Onder
AU - Melk, Anette
AU - Querfeld, Uwe
AU - Wühl, Elke
AU - Kretzler, Matthias
AU - Schaefer, Franz
AU - 4C Study
AU - ESCAPE Trial Group
AU - Oh, Jun
N1 - Copyright © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
PY - 2019/7
Y1 - 2019/7
N2 - 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.
AB - 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.
U2 - 10.1016/j.kint.2019.01.035
DO - 10.1016/j.kint.2019.01.035
M3 - SCORING: Journal article
C2 - 31005273
VL - 96
SP - 214
EP - 221
JO - KIDNEY INT
JF - KIDNEY INT
SN - 0085-2538
IS - 1
ER -
