A bstract B etaig-h3 (βig-h3) is a secretory pro tein compo sed of fasciclin I-like repeats con tainin g sequ en ces that allo w s bind ing of integrins and glycosam in oglycan s in vivo . E xpression of βig -h3 is respon sive to T G F-β an d the p rotein is found to be associated w ith extracellular m atrix (E C M ) m o lecu les, im p licatin g βig-h3 as an E C M adhesive pro tein o f d evelopm ental processes. W e p reviou sly observed p red om inant expression of βig-h3 expression in the basem ent m embrane o f proxim al tubu les o f kid ney. In this stu dy, the p hysio logical relevance of su ch localized expression of βig-h3 was exam ined in the renal proxim al tubular epithelial cells (RPTEC). R P T E C constitu tively exp ressed βig -h 3 and the exp ression w as dram atically ind uced b y exogenous TG F-β1 treatm ent. βig-h3 and its second and fou rth F A S 1 dom ain w ere able to m ed iate R P TE C adhesion, spreading and m igration. Tw o know n α3β1 integrin-interaction m otifs including aspartatic acid and isoleucine resid ues, N K D IL an d E P D IM in βig -h 3 w ere resp o n sib le to m ed iate R P T E C ad hesio n, sp readin g, an d m igratio n. B y using specific an tib odies against in tegrin s, w e confirm ed that α3 β1 in teg rin m ed iates th e adh esion and m ig ration of R P T E C s on βig -h 3. In ad dition, it also en hanced proliferation of R P TE C s th roug h N K D IL and E P D IM . These results ind icate th at βig-h3 m ediates adh esion , spreading, m igration and proliferation of R P TE C s th ro u g h th e in teractio n w ith α3β1 in teg rin an d is in tim ately in vo lved in th e m ain ten an ce an d the regeneratio n o f ren al proxim al tubu lar ep ith eliu m .

Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.