Renal expression of monocyte chemotactic protein-1 and epidermal growth factor in children with obstructive hydronephrosis

Background/Purpose: The authors studied the potential role of ureteropelvic junction obstruction (UPJ-O) in causing progressive renal damage in childr en through the renal expression of epidermal growth factor (EGF) and monocy te chemotactic protein-1 (MCP-1) mRNA. Methods: Renal tissues were harvested from 11 children with UPJ-O and from 10 normal kidneys to study the renal expression of EGF and MCP-1 detected b y means of in situ hybridization. Five of the patients were found to have a history of urinary tract infection (UTI), Results: Children with UPJ-O had marked reduction of EGF gene expression wh en compared with controls. Interstitial expression of MCP-1 mRNA was presen t in all UPJ-O cases. Both EGF and MCP-1 expression did not correlate with age, with differential renal function, and with renal thickness measured th rough MAG3 renal scan. Children with a history of UTI had a more severe red uction of the renal thickness of the affected kidney compared with those wi thout UTI. MCP-1 expression was higher and EGF more reduced in children wit h a history of UTI. Conclusions: Our results suggest a potential role of EGF and MCP-1 in the p athogenesis of renal damage and growth failure in UPJ-O, especially in chil dren with UTI. These important functional changes begin early in life, poss ibly during fetal life. Copyright (C) 2000 by W.B. Saunders Company.