Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney

Wasilewska, Anna; Zoch-Zwierz, W; Taranta-Janusz, Katarzyna

doi:10.1007/s00467-008-1045-1

Cited by 13 publications

(10 citation statements)

References 58 publications

(62 reference statements)

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“…[24]. The TGFβ-1 urinary levels in our series, both in the controls and patients, were also similar to the findings of Wasilewska et al [24].…”

Section: Discussionsupporting

confidence: 80%

“…[24]. The TGFβ-1 urinary levels in our series, both in the controls and patients, were also similar to the findings of Wasilewska et al [24]. In summary, we studied the usefulness of the urinary excretion of TGFβ-1 as an early and noninvasive biomarker of renal hemodynamic changes due to a reduction in the number of functioning nephrons in D+HUS patients.…”

Section: Discussionsupporting

confidence: 69%

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Levels of urinary transforming growth factor β-1 in children with D+ hemolytic uremic syndrome

2010

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About 25-50% of survivors of the acute phase of postdiarrheal hemolytic uremic syndrome (D+ HUS) develop chronic renal disease. Transforming growth factor beta-1 (TGFbeta-1) is the main fibrogenic growth factor in humans, and there is a significant correlation between its levels and the grade of interstitial fibrosis in chronic nephropathies. We hypothesized that increased urinary TGFbeta-1 may be an early indicator of sequelae in D+ HUS patients who show no sign of renal damage as determined by conventional diagnostic tests. We therefore compared the levels of TGFbeta-1 in urine collected from healthy controls (HC) (n = 18) with that from patients with a past history of D+ HUS (n = 39). We found that TGFbeta-1 excretion was significantly higher (p < 0.001) in the patient group (median level 73 pg/mg creatinine) than in the HC (median level 28 pg/mg creatinine). TGFbeta-1 excretion did not correlate with age, white blood cell count, length of oligoanuric period, maximum creatinine at the acute stage, or length of the follow-up. Since TGFbeta-1 excretion may reflect ongoing renal tissue damage, our results emphasize the need for the lifelong follow-up of patients with a past history of D+ HUS, even those showing apparent recovery. Long-term monitoring of this cohort is necessary to determine the clinical utility of our findings.

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“…[24]. The TGFβ-1 urinary levels in our series, both in the controls and patients, were also similar to the findings of Wasilewska et al [24].…”

Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 69%

Levels of urinary transforming growth factor β-1 in children with D+ hemolytic uremic syndrome

2010

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“…It has been speculated that the production of active fibrotic cytokines recognized in several kidney diseases as markers of disease activity and histopathological deterioration, might also be increased in the set of obesity (23). Such substances were shown to be increased in children with congenital single kidney in comparison with controls, even in early phases of hyperfiltration when proteinuria and renal insufficiency are still absent (24). Since kidney diseases with reduced renal mass are believed to mimic what happens in obesity, representing the clinical translation of the experimental hyperfiltration models (25), the increased levels of these substances, promoted in the proinflammatory and pro-oxidant setting of obesity, might partially explain the kidney impairment observed.…”

Section: Articlesmentioning

confidence: 87%

Decreased renal function in overweight and obese prepubertal children

et al. 2015

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Background: Obesity is a potentially modifiable risk factor for the development and progression of kidney disease, both in adults and children. We aim to study the association of obesity and renal function in children, by comparing estimated glomerular filtration rate (eGFR) in nonoverweight and overweight/obese children. Secondarily, we aim to evaluate the accuracy of equations on eGFR estimation when compared to 24-h urinary creatinine clearance (CrCl). Methods: Cross-sectional study of 313 children aged 8-9 y, followed in the birth cohort Generation XXI (Portugal).Creatinine and cystatin C, GFR estimated by several formulas and CrCl were compared in 163 nonoverweight and 150 overweight/obese, according to World Health Organization growth reference. results: Overweight/obese children had significantly lower eGFR, estimated by all methods, except for CrCl and revised Schwartz formula. Despite all children having renal function in the normal range, eGFR decreased significantly with BMI z-score (differences ranging from −4.3 to −1.1 ml/min/1.73 m 2 per standard deviation of BMI). The Zappitelli combined formula presented the closest performance to CrCl, with higher correlation coefficients and higher accuracy values. conclusion: Young prepubertal children with overweight/ obesity already present significantly lower GFR estimations that likely represent some degree of renal impairment associated with the complex deleterious effects of adiposity. t he role of the obesity epidemic in the risk of kidney disease has been recognized in adults, independently of diabetes, with the prevalence of end-stage renal disease raising tremendously in the past 3 decades in parallel with the increased prevalence of obesity (1,2). Obesity was also identified as a strong and potentially modifiable risk factor for the development and progression of kidney disease (3,4) and, in children, recent data confirmed a similar trend, with obesity contributing to renal injury and to an important increase of chronic kidney disease (5).Studies in the general pediatric population only recently started to arise and the results concerning glomerular filtration rate (eGFR) differences in obese and normal weight children are somehow contradictory; some studies reported higher eGFR in obese children reflecting a state of hyperfiltration (6), while others found either the opposite (7,8) or no differences (9,10).It is difficult to evaluate renal function in the general pediatric population and to which extent the kidney is involved in the metabolic cluster of conditions that emerge with the onset of obesity in early ages. On the one hand, since exogenous and more accurate, but invasive, methods are not justifiable to apply in healthy children, one has to rely on eGFR formulas or in the 24-h urine creatinine clearance (CrCl). However, formulas to estimate eGFR are known to have some limitations and 24-h urine samples might be difficult to reliably obtain in children (11). On the other hand, the degree of kidney involvement related to obesity might be subt...

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Section: Discussionmentioning

confidence: 99%

“…Wasilewska et al [9] reported increased levels of serum uric acid in children with congenital solitary kidney. In adults, hyperuricemia is an independent risk factor for new-onset chronic kidney disease (CKD) [9, 10], and has been suggested to be an early indicator of renal dysfunction [11]. While uric acid is known to be an early marker for developing hypertension [12], it has not been paid much attention in many previous studies on solitary functioning kidney in children.…”

Section: Discussionmentioning

confidence: 99%

Trajectory of Estimated Glomerular Filtration Rate Predicts Renal Injury in Children with Multicystic Dysplastic Kidney

Matsumura¹,

Sugii²,

Awazu³

2018

Nephron

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Background/Aims: Children with a solitary functioning kidney have a risk of renal injury caused by hyperfiltration. Timely intervention with renin-angiotensin inhibitors may be beneficial. We examined whether trajectory of estimated glomerular filtration rate (eGFR) would predict renal injury, defined as microalbuminuria/proteinuria, hypertension, and/or a decline in eGFR. Methods: Seventeen patients (male 7, female 10) with multicystic dysplastic kidney (MCDK; median age 13 years, range 6–19 years) followed in our clinic were examined retrospectively. An eGFR decline was defined as a fall to < 90 mL/min/1.73 m² or a decline of > 5 mL/min/1.73 m²/year for those with baseline eGFR of ≥90 or < 90 mL/min/1.73 m² respectively. Results: Nine patients had renal injury at the time of investigation. Compared with 8 patients without renal injury, those with renal injury tended to be older (14.7 ± 4.2 vs. 11.4 ± 4.6 years) and the birth weight was smaller (2,538 ± 281 vs. 2,966 ± 361 g, p < 0.05). The frequency of contralateral congenital anomaly of kidney and urinary tract (cyst, hydronephrosis, or vesicoureteral reflux) were not different. The trajectory of eGFR in those without renal injury was either an increase (n = 3) or unidentifiable (n = 5), whereas that in the renal injury group was exclusively an increase followed by decline (p < 0.05). The average age of the onset of eGFR decline was 9.4 ± 4.2 years and that of the start of renal injury (albuminuria/proteinuria 5, eGFR decline 4, hypertension 1) was 12.5 ± 4.2 years. Conclusion: All the children with MCDK who developed renal injury had eGFR trajectory of increase followed by decline. Renal injury followed the peak eGFR by 3 years on average. This observation is in agreement with the hyperfiltration theory and underscores the importance of following eGFR trajectory closely.

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Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney

Cited by 13 publications

References 58 publications

Levels of urinary transforming growth factor β-1 in children with D+ hemolytic uremic syndrome

Levels of urinary transforming growth factor β-1 in children with D+ hemolytic uremic syndrome

Decreased renal function in overweight and obese prepubertal children

Trajectory of Estimated Glomerular Filtration Rate Predicts Renal Injury in Children with Multicystic Dysplastic Kidney

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