Urinary epidermal growth factor in different renal conditions in children

Several studies have demonstrated the important role of growth factors; particularly epidermal growth factor (EGF) and transforming growth factor alpha (TGF alpha), in cellular growth after renal damage. EGF is mainly synthesized by the kidney. Many studies indicate that urinary EGF concentration significantly decreases in patients with acute and chronic renal failure. In this study we determined urinary EGF concentrations in children with renal and/or urological pathologies. We investigated 38 patients, 17 males and 21 females, of 3.34 +/- 2.96 years (mean +/- standard deviation), who were followed in the Nephrologic Unit of the Pediatric Department of the University of Verona for recurrent urinary tract infections: seven of these had vesicoureteric reflux and 4 had hypodysplasia. The results were compared with those from a healthy age-matched group of 44 children. In all patients, we assessed renal function including an examination of the urine with a microbiological evaluation. Moreover, a renal ultrasound: and a voiding cystourethrogram were performed. Urinary EGF was measured by a radioimmunoassay, using polyclonal goat antibodies. In all patients, laboratory parameters were within the normal range. In 34 patients the renal ultrasound was negative and in 4 cases structural alterations of the renal parenchyma were found. Voiding cystourethrography detected 7 instances of vesicoureteric reflux. In controls 10 degrees, 50 degrees, 90 degrees percentile uEGF values were 7.3, 19 and 40.4 mug/L, respectively. Mean urinary EGF values were 22.22 +/- 16 mug/L. Urinary EGF values were 54 +/- 35.2 mug/L in patients with recurrent urinary tract infections and without urinary malformations, 81 +/- 29.37 mug/L in patients with vesicoureteric reflux and 22.30 +/- 22.90 mug/L in patients with hypodysplasia, respectively: There was a statistical significant difference between controls and groups A (p < 0.001) and B (p < 0.001) respectively, while the difference between group C and controls wasn't significant (p = 0.044). Results are reported in Figure 1. We believe that our results could be helpful for further studies on pathophysiology of growth factors in different renal conditions of children.