GDF-15 and uEGF Independently Associate With CKD Progression in Children
Makaleler > Tam Makale · 2025
Yazarlar: Julia Bartels, Mansoureh Tabatabaeifar, Marietta Kirchner, Karolis Azukaitis, Anke Doyon, Aysun Bayazit, Ali Düzova, Nur Canpolat, İpek KAPLAN BULUT, Lukasz Obrycki, Bruno Ranchin, Rukshana Shroff, Francesca Lugani, Cengiz Candan, Jerome Harambat, Harika Alpay, Mieczyslaw Litwin, Augustina Jankauskiene, Günter Klaus, Dorota Drozdz, Giovanni Montini, Aleksandra Zurowska, Alberto Caldas Afonso, Elke Wühl, Anette Melk, Uwe Querfeld, Otto Mehls, Franz Schaefer, G. Cortina, K. Arbeiter, J. Dusek, J. Harambat, B. Ranchin, M. Fischbach, A.Zalosczyk, U. Querfeld, S.Habbig, M. Galiano, R. Büscher, C. Gimpel, M. Kemper, A. Melk, D. Thurn, F. Schaefer, A. Doyon, E. Wühl, M. Pohl, S. Wygoda, N. Jeck, B. Kranz, M. Wigger, G. Montini, F. Lugani, S. Testa, E. Vidal, C. Matteucci, S. Picca, A. Jankauskiene, K. Azukaitis, A. Zurowska, D. Drodz, M. Tkaczyk, T. Urasinski, M. Litwin, A.Niemirska, M. Szczepanska, A. Texeira, A. Peco-Antic, B.Bucher, G. Laube, A. Anarat, A.K. Bayazit, F. Yalcinkaya, E. Basin, N. Cakar, O. Soylemezoglu, A. Düzova, Y. Bilginer, H. Erdogan, O. Donmez, A. Balat, A. Kiyak, S. Caliskan, N. Canpolat, C. Candan, M. Civilibal, S. Emre, G. Ozcelik, S. Mir, B. Sözeri, O. Yavascan, Y. Tabel, P. Ertan, E. Yilmaz, R. Shroff
Kidney International Reports, Uluslararası, Wos, 2025, cilt 10, ss 3369-3378
DOI: 10.1016/j.ekir.2025.07.004
Özet
Introduction Currently, there is limited ability to predict the progression of chronic kidney disease (CKD) in children. Previously we reported that low levels of urinary epidermal growth factor (uEGF) predict CKD progression in children. In the present study we investigated a novel serum biomarker – growth differentiation factor 15 (GDF-15), in two European pediatric CKD cohorts. We additionally explored the combined effect of GDF-15 and/or urinary EGF on CKD progression in children. Methods The association between serum GDF-15 levels and CKD progression was analyzed in 671 patients of the Cardiovascular Comorbidity in Children with CKD (4C) study, aged 6-17 years with an estimated glomerular filtration rate (eGFR) of 10-60 ml/min per 1.73 m 2 at baseline, and median follow-up of 8 years. The composite endpoint was start of kidney replacement therapy, 50% eGFR loss, or eGFR <10 ml/min per 1.73 m 2 . Results were validated in 329 participants from the ESCAPE trial. Results Higher GDF-15 levels were associated with an increased risk of CKD progression (HR 1.40; 95% CI 1.10-1.77) independent of age, sex, baseline eGFR, proteinuria, and systolic blood pressure. While adding either GDF-15 or uEGF individually to a model containing these variables improved model fit, combining both markers improved the model further. External validation in the ESCAPE cohort confirmed these results. Conclusion Serum GDF-15 and urine EGF levels may provide complementary information on the risk of CKD progression in children and might be included in future prognostic biomarker panels aimed at personalized, risk-stratified management of pediatric CKD.