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Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study

Graft failure (GF) remains a significant limitation to improve long-term outcomes in renal transplant recipients (RTR). Urinary epidermal growth factor (uEGF) is involved in kidney tissue integrity, with a reduction of its urinary excretion being associated with fibrotic processes and a wide range o...

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Autores principales: Yepes-Calderón, Manuela, Sotomayor, Camilo G., Kretzler, Matthias, Gans, Rijk O. B., Berger, Stefan P., Navis, Gerjan J., Ju, Wenjun, Bakker, Stephan J. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832301/
https://www.ncbi.nlm.nih.gov/pubmed/31614925
http://dx.doi.org/10.3390/jcm8101673
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author Yepes-Calderón, Manuela
Sotomayor, Camilo G.
Kretzler, Matthias
Gans, Rijk O. B.
Berger, Stefan P.
Navis, Gerjan J.
Ju, Wenjun
Bakker, Stephan J. L.
author_facet Yepes-Calderón, Manuela
Sotomayor, Camilo G.
Kretzler, Matthias
Gans, Rijk O. B.
Berger, Stefan P.
Navis, Gerjan J.
Ju, Wenjun
Bakker, Stephan J. L.
author_sort Yepes-Calderón, Manuela
collection PubMed
description Graft failure (GF) remains a significant limitation to improve long-term outcomes in renal transplant recipients (RTR). Urinary epidermal growth factor (uEGF) is involved in kidney tissue integrity, with a reduction of its urinary excretion being associated with fibrotic processes and a wide range of renal pathologies. We aimed to investigate whether, in RTR, uEGF is prospectively associated with GF. In this prospective cohort study, RTR with a functioning allograft ≥1-year were recruited and followed-up for three years. uEGF was measured in 24-hours urine samples and normalized by urinary creatinine (Cr). Its association with risk of GF was assessed by Cox-regression analyses and its predictive ability by C-statistic. In 706 patients, uEGF/Cr at enrollment was 6.43 [IQR 4.07–10.77] ng/mg. During follow-up, 41(6%) RTR developed GF. uEGF/Cr was inversely associated with the risk of GF (HR 0.68 [95% CI 0.59–0.78]; P < 0.001), which remained significant after adjustment for immunosuppressive therapy, estimated Glomerular Filtration Rate, and proteinuria. C-statistic of uEGF/Cr for GF was 0.81 (P < 0.001). We concluded that uEGF/Cr is independently and inversely associated with the risk of GF and depicts strong prediction ability for this outcome. Further studies seem warranted to elucidate whether uEGF might be a promising marker for use in clinical practice.
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spelling pubmed-68323012019-11-21 Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study Yepes-Calderón, Manuela Sotomayor, Camilo G. Kretzler, Matthias Gans, Rijk O. B. Berger, Stefan P. Navis, Gerjan J. Ju, Wenjun Bakker, Stephan J. L. J Clin Med Article Graft failure (GF) remains a significant limitation to improve long-term outcomes in renal transplant recipients (RTR). Urinary epidermal growth factor (uEGF) is involved in kidney tissue integrity, with a reduction of its urinary excretion being associated with fibrotic processes and a wide range of renal pathologies. We aimed to investigate whether, in RTR, uEGF is prospectively associated with GF. In this prospective cohort study, RTR with a functioning allograft ≥1-year were recruited and followed-up for three years. uEGF was measured in 24-hours urine samples and normalized by urinary creatinine (Cr). Its association with risk of GF was assessed by Cox-regression analyses and its predictive ability by C-statistic. In 706 patients, uEGF/Cr at enrollment was 6.43 [IQR 4.07–10.77] ng/mg. During follow-up, 41(6%) RTR developed GF. uEGF/Cr was inversely associated with the risk of GF (HR 0.68 [95% CI 0.59–0.78]; P < 0.001), which remained significant after adjustment for immunosuppressive therapy, estimated Glomerular Filtration Rate, and proteinuria. C-statistic of uEGF/Cr for GF was 0.81 (P < 0.001). We concluded that uEGF/Cr is independently and inversely associated with the risk of GF and depicts strong prediction ability for this outcome. Further studies seem warranted to elucidate whether uEGF might be a promising marker for use in clinical practice. MDPI 2019-10-13 /pmc/articles/PMC6832301/ /pubmed/31614925 http://dx.doi.org/10.3390/jcm8101673 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yepes-Calderón, Manuela
Sotomayor, Camilo G.
Kretzler, Matthias
Gans, Rijk O. B.
Berger, Stefan P.
Navis, Gerjan J.
Ju, Wenjun
Bakker, Stephan J. L.
Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study
title Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study
title_full Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study
title_fullStr Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study
title_full_unstemmed Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study
title_short Urinary Epidermal Growth Factor/Creatinine Ratio and Graft Failure in Renal Transplant Recipients: A Prospective Cohort Study
title_sort urinary epidermal growth factor/creatinine ratio and graft failure in renal transplant recipients: a prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832301/
https://www.ncbi.nlm.nih.gov/pubmed/31614925
http://dx.doi.org/10.3390/jcm8101673
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