The Ratio of Epidermal Growth Factor (EGF) to Monocyte Chemotactic Peptide-1 (MCP1) in the Urine May Predict Renal Prognosis in HTx

Abstract

Purpose Heart transplant recipients (HTx) have increased mortality rates when they advance toward renal insufficiency. Being able to predict whether renal failure will progress should be a major target to improve outcomes after HTx. Kidneys with tubulointerstitial damage exhibit a decreased urinary excretion of EGF. Conversely, MCP1 plays a major role in the progression of renal disease. Thus, EGF/MCP-1 ratio measurement might help to predict the progressive deterioration of renal function. Methods and Materials Preliminarly, we measured EGF/MCP1 in 517 urinary samples to assess whether this ratio had any relationship with creatinine, estimated glomerular filtration rate measured as MDRD, albuminuria or proteinuria. Then we conducted a retrospective case-control study in 24 HTx patients with mild renal dysfunction. Patients whose renal function has deteriorated (cases) were matched for age, gender, f-up, creatinine and MDRD with patients with stable renal function (controls). Results In all samples there were significant negative linear relationship between EGF/MCP1 and creatinine (p Conclusions The degree of urinary EGF/MCP1 excretion has a linear relationship with creatinine, proteinuria and estimated glomerular filtration rate. EGF/MCP1 excretion predicts renal outcomes and may be useful to identify HtTx patients at higher risk for progression of renal failure.