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Role of tubulointerstitial injury in ANCA-associated vasculitis is underestimated
  1. Nikolai Bulanov,
  2. Natalia V Chebotareva,
  3. Pavel I Novikov,
  4. Sergey V Moiseev
  1. Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russian Federation
  1. Correspondence to Professor Sergey V Moiseev, Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Rossolimo, 11/5, Moscow, 119435, Russian Federation ; clinpharm{at}

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Available evidence suggests that epidermal growth factor (EGF) is decreased in patients with kidney diseases and may predict deterioration of kidney function.1 2 In the kidney, EGF is expressed in the ascending portion of the Henle’s loop and the distal tubule. EGF binds to the specific EGF receptors and is involved in the regulation of cell proliferation, migration, growth and differentiation. EGF is a main trophic factor for tubular cells and modulates tissue response to injury. In the recently published study, Wu et al 3 showed that a lower urinary EGF level was associated with a more severe renal disease, refractoriness to the immunosuppressive treatment, and a higher risk of progression to the composite endpoint that included end-stage renal disease and at least 30% decline in estimated glomerular filtration rate (eGFR) in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). In a multivariable Cox regression analysis, urinary EGF/creatinine remained an independent predictor for the composite endpoint (HR 0.61, 95% CI 0.45 to 0.83, p=0.001) after adjusting for age, gender, eGFR, urinary protein at renal biopsy, type of ANCA and treatment protocols. The authors suggested that urinary EGF/creatinine …

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  • Handling editor Josef Smolen

  • Contributors All authors participated in the preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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