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Levels of urinary transforming growth factor β-1 in children with D+ hemolytic uremic syndrome

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Abstract

About 25–50% of survivors of the acute phase of postdiarrheal hemolytic uremic syndrome (D+ HUS) develop chronic renal disease. Transforming growth factor β-1 (TGFβ-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 TGFβ-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 TGFβ-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 TGFβ-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). TGFβ-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 TGFβ-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.

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Acknowledgments

We would like to thank Dr. Ana Fernandez Ruiz for her help in recruiting the healthy controls. This study was supported by a grant from the Consejo de Investigaciones de la Ciudad Autónoma de Buenos Aires to MG.C. and by a research grant "Adolfo H Aztiria" to A.B. from the Academia Nacional de Medicina, Ciudad Autónoma Buenos Aires. Argentina.

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Authors and Affiliations

  1. Department of Nephrology, Prof. Dr. Juan P. Garrahan Children’s Hospital, Combate de los Pozos 1881, 1245, Buenos Aires, Argentina

    María Gracia Caletti & Alejandro Balestracci

  2. Laboratory of Immunology, Prof. Dr. Juan P. Garrahan Children’s Hospital, Combate de los Pozos 1881, 1245, Buenos Aires, Argentina

    Adriana Haydeé Roy

Authors
  1. María Gracia Caletti
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  2. Alejandro Balestracci
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  3. Adriana Haydeé Roy
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Correspondence to María Gracia Caletti.

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Caletti, M.G., Balestracci, A. & Roy, A.H. Levels of urinary transforming growth factor β-1 in children with D+ hemolytic uremic syndrome. Pediatr Nephrol 25, 1177–1180 (2010). https://doi.org/10.1007/s00467-009-1434-0

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  • DOI: https://doi.org/10.1007/s00467-009-1434-0

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