Urinary levels of epidermal growth factor, interleukin-6 and monocyte chemoattractant protein-1 may act as predictor markers of renal function outcome in immunoglobulin A nephropathy

• Published in: Nephrology (Carlton, Vic.) Vol. 14; no. 6; pp. 613 - 620
• Main Authors: STANGOU, MARIA, ALEXOPOULOS, EFSTATHIOS, PAPAGIANNI, AIKATERINI, PANTZAKI, AFRODITI, BANTIS, CHRISTOS, DOVAS, SPIROS, ECONOMIDOU, DOMNIKI, LEONTSINI, MARIA, MEMMOS, DIMITRIOS
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.09.2009
• Subjects: Adolescent; Adult; Aged; Biomarkers; Chemokine CCL2 - urine; epidermal growth factor; Epidermal Growth Factor - urine; Female; fibrosis; Glomerulonephritis, IGA - pathology; Glomerulonephritis, IGA - physiopathology; Glomerulonephritis, IGA - urine; Humans; immunoglobulin A nephropathy; interleukin-6; Interleukin-6 - urine; Kidney - physiopathology; Male; Middle Aged; monocyte chemoattractant protein-1; proteinuria
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/j.1440-1797.2008.01051.x

Aim:  Urinary cytokine excretion may reflect histological changes in immunoglobulin A nephropathy (IgAN), and their measurement can give information about disease outcome. Methods:  Thirty‐three IgAN patients were prospectively followed for 5.6 ± 3.1 years. Urinary levels of monocyte chemoattractant protein‐1 (MCP‐1), interleukin (IL)‐6 and epidermal growth factor (EGF) were measured at diagnosis and repeated 1 year later for IL‐6 and EGF. Results:  Urinary MCP‐1 and IL‐6 levels were increased significantly, while EGF excretion reduced in IgAN patients, compared to controls. IL‐6 urinary levels showed significant positive correlation with chronic histological lesions. Patients were classified into five groups, according to the Haas classification system. MCP‐1 and IL‐6 urinary levels were increased, whereas EGF levels were reduced in the progression of staging. EGF urinary excretion was a strong predictor factor of disease outcome, significantly correlated with creatinine clearance at time of diagnosis (r = 0.5, P = 0.005), and at the end of follow up (r = 0.6, P = 0.001). Urinary EGF levels measured a year later could predict long‐term outcome better, and a cut of 0.05 pg/mg urine creatinine levels could distinguish between progressors and non‐progressors. Conclusion:  Urinary MCP‐1, IL‐6 and EGF levels may represent histology in IgAN. EGF excretion can be a predictive marker and its serial measurements may give information about disease outcome and the effect of treatment.