Levels of urinary transforming growth factor beta-1 in children with D+ hemolytic uremic syndrome.
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.
Department of Nephrology, Prof. Dr. Juan P. Garrahan Children's Hospital, Combate de los Pozos 1881, 1245 Buenos Aires, Argentina. mcaletti@garrahan.gov.ar
María Gracia
MG
Caletti
Alejandro
A
Balestracci
Adriana Haydeé
AH
Roy
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000652:urine*; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000652:urine; D008297:Male; D053773:Transforming Growth Factor beta1 / Q000652:urine*
D053773:Transforming Growth Factor beta1