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Reduced Urinary Excretion of Epidermal Growth Factor in Incipient and Overt Diabetic Nephropathy
Author(s) -
Mathiesen E. R.,
Nexø E.,
Hommel E.,
Parving H.H.
Publication year - 1989
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1989.tb02098.x
Subject(s) - endocrinology , excretion , medicine , diabetic nephropathy , renal function , epidermal growth factor , microalbuminuria , urinary system , nephropathy , kidney , diabetes mellitus , receptor
To study the relationship between glomerular and tubular function we investigated glomerular filtration rate (GFR), urinary albumin excretion, and urinary excretion of epidermal growth factor (EGF, a mitogenic peptide synthesized in the renal tubular cells) in normal subjects (group I, n = 7) and in Type 1 (insulin‐dependent) diabetic patients with normoalbuminuria (group II, n = 11); with incipient nephropathy (microalbuminuria) (group III, n = 9); with nephropathy and normal GFR (group IV, n = 12); and with reduced GFR (group V, n = 8). EGF (nmol 24 h ‐1 ) decreased with progressive glomerular involvement, from 7.9 (4.1–10.5) (median and range) in group I, to 6.7 (1.3–9.2) in group II, 5.0 (3.6–7.4) in group III, 4.1 (2.5–9.5) in group IV, and 1.1 (0.1–2.5) in group V. The urinary excretion of EGF was significantly reduced in patients with elevated UAE (group III, IV, and V) compared with normal control subjects ( p < 0.05). A significant correlation between urinary excretion of EGF and GFR ( r = 0.71, p < 0.001) and an inverse correlation between the urinary excretion of EGF and albumin ( r = ‐0.35, p < 0.05) was demonstrated in the Type 1 diabetic patients with GFR>90 ml min ‐1 . Our study demonstrates that urinary excretion of epidermal growth factor diminishes with increasing nephron impairment, and that renal tubular function as judged by the excretion of EGF is reduced early in the development of diabetic kidney disease.