Is there any relation between connective tissue growth factor and scar tissue in vesicoureteral reflux?

Özet

Vesicoureteral reflux (VUR) is the most common uropathy in childhoodwhich leads to increased frequency of urinary tract infection (UTI) andrenal scarring. Connective tissue growth factor (CTGF) plays an importantrole in the development of glomerular and tubulointerstitial fibrosis inprogressive kidney diseases. The aim of this study was to investigate therelation between urinary CTGF and renal damage resulted from VUR. Thiscross sectional study included 70 patients with VUR and 62 healthy sex andage matched children. Urinary creatinine and CTGF (uCTGF) concentrationswere analysed in all cases and CTGF to creatinine ratio were calculated.The records of radiologic evaluations of the patients including ultrasound,voiding cystouretrography and 99m-technetium dimercaptosuccinic acid(DMSA) scintigraphy were obtained retrospectively. The patient group wasfurther divided into two groups according to the existence of renal corticalscarring in the DMSA scan. The study consisted of three groups; Group1 (control group) 62 children, Group 2 (VUR positive, scar negative) 24patient, Group 3 (VUR positive, scar positive) 46 patient (VUR+scar). Themedians of uCTGF and uCTGF to creatinine ratio of the three groups weresignificantly different (p <0.001). Pairwise group comparisons revealed thatGroup 1 had significantly lower uCTGF level and uCTGF/creatinine ratio, ascompared to Groups 2 and 3 (p <0.001 and p=0.002, respectively). Therewas no statistically significant difference between Groups 2 and 3 (p=0.052).uCTGF is significantly increased in children with VUR, independent on thepresence of renal scarring. Increased uCTGF, even in the absence of the renalscarring, could be interpreted as development and a progression of glomerularand tubulointerstitial fibrosis in vesicoureteral reflux. Further experimentaland clinical investigations are required to fully elucidate the mechanism ofCTGF in vesicoureteral reflux.