Urinary epidermal growth factor predicts complete remission of proteinuria in Chinese children with IgA nephropathy

Abstract

Background This study investigated the association between urinary epidermal growth factor (EGF) and complete remission (CR) of proteinuria in children with IgA nephropathy (IgAN). Methods We included 108 patients from the Registry of IgA Nephropathy in Chinese Children. The urinary EGF at the baseline and follow-up were measured and normalized by urine creatinine (expressed as uEGF/Cr). The person-specific uEGF/Cr slopes were estimated using linear mixed-effects models for the subset of patients with longitudinal data of uEGF/Cr. Cox models were used to analyze the associations of baseline uEGF/Cr and uEGF/Cr slope with CR of proteinuria. Results Patients with high baseline uEGF/Cr were more likely to achieve CR of proteinuria (adjusted HR 2.24, 95% CI: 1.05–4.79). The addition of high baseline uEGF/Cr on the traditional parameters significantly improved the model fit for predicting CR of proteinuria. In the subset of patients with longitudinal data of uEGF/Cr, high uEGF/Cr slope was associated with a higher likelihood of CR of proteinuria (adjusted HR 4.03, 95% CI: 1.02–15.88). Conclusions Urinary EGF may be a useful noninvasive biomarker for predicting and monitoring CR of proteinuria in children with IgAN. Impact High levels of baseline uEGF/Cr (>21.45 ng/mg) could serve as an independent predictor for CR of proteinuria. The addition of baseline uEGF/Cr on the traditional clinical pathological parameters significantly improved the fitting ability for the prediction of CR of proteinuria. Longitudinal data of uEGF/Cr were also independently associated with CR of proteinuria. Our study provides evidence that urinary EGF may be a useful noninvasive biomarker in the prediction of CR of proteinuria as well as monitoring therapeutic response, thus guiding treatment strategies in clinical practice for children with IgAN.

Machine learning-based diagnosis and prognosis of IgAN: A systematic review and meta-analysis

“…A total of 1053 papers were searched. After excluding papers with irrelevant topics, 1 studies [ 27 ] with fewer than 50 cases, 6 [ 9 , 15 , 18 , 24 , 28 , 29 ] with insufficient statistics, and 5 [ [30] , [31] , [32] , [33] , [34] ] reported in Child were excluded according to a full-text review, the remaining 47 [ 7 , 14 , [20] , [21] , [22] , [23] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] ] studies were eligible for meta-analysis. Of the 47 eligible studies, 12 and 27 [ 7 , 14 , [20] , [21] , …”

Intraindividual variations of urinary biomarkers in hospitalized children with glomerular diseases: a prospective observational study

“…Urinary biomarkers have been widely used and investigated in making diagnoses and therapy regimens and estimating the prognosis of pediatric glomerular diseases. These biomarkers include both commonly used urinary biomarkers (urinary protein [ 1 ], albumin [ 2 ], and N-acetyl-beta-D-glucosaminidase [ 3 ]) and novel molecular markers (epidermal growth factor (EGF) [ 4 – 11 ]). Urinary protein has been acknowledged as one of the most critical risk factors [ 1 ].…”