Greenberg JH, Abraham AG, Xu Y, et al. - Among children, a lower urine EGF level and higher urine KIM-1 (kidney injury molecule-1), MCP-1 (monocyte chemoattractant protein-1), and α-1 microglobulin levels were each associated with CKD progression, post-multivariable adjustment.

• Children aged 6 months to 16 years with an eGFR of 30–90ml/min per 1.73m ² were included in the prospective CKD in Children Study.

• A median follow-up of 6.5 years showed a composite outcome (a composite of a 50% reduction in eGFR or renal failure) occurred in 252 of 665 children (38%).

• Post-adjustment, a seven-fold higher risk of CKD progression was evident in children with urine EGF levels in the lowest quartile vs the highest quartile (fully adjusted hazard ratio, 7.1).

• A significantly higher risk of CKD progression was observed in the highest quartile of urine KIM-1, MCP-1, and α-1 microglobulin levels vs the lowest quartile.

• Increased discrimination and reclassification for CKD progression was achieved by adding the five biomarkers (EGF, α-1 microglobulin, KIM-1, MCP-1, YKL-40) to a clinical model.