Serum levels of beta-trace protein and its association to diuresis in haemodialysis patients

Gerhardt, Thomas; Pöge, Uwe; Stoffel‐Wagner, Birgit; Klein, Burkhard; Klehr, H. U.; Sauerbruch, Tilman; Woitas, Rainer P.

doi:10.1093/ndt/gfm510

Cited by 31 publications

(47 citation statements)

References 17 publications

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“…Similar to cystatin C and other low molecular weight proteins, BTP is freely filtered by the glomerulus, and it is completely reabsorbed and metabolized by the proximal tubule (37). Serum BTP levels increase as urine output declines in hemodialysis patients (16). BTP is not removed by low-or high-flux hemodialysis membranes during conventional hemodialysis (16).…”

Section: Discussionmentioning

confidence: 99%

“…Serum BTP levels increase as urine output declines in hemodialysis patients (16). BTP is not removed by low-or high-flux hemodialysis membranes during conventional hemodialysis (16). Hemodiafiltration, a specialized type of dialysis not performed for maintenance dialysis in the United States, can remove BTP (16,33).…”

Section: Discussionmentioning

confidence: 99%

“…BTP is not removed by low-or high-flux hemodialysis membranes during conventional hemodialysis (16). Hemodiafiltration, a specialized type of dialysis not performed for maintenance dialysis in the United States, can remove BTP (16,33). These characteristics suggest that serum BTP may serve as a useful biomarker for GFR estimation in hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike urea, creatinine, and cystatin C, it is not removed by hemodialysis because of its higher molecular weight. Serum levels of BTP are highly correlated with measured GFR (13)(14)(15) and have been shown to correlate with RKF (16), but their association with long-term outcomes in dialysis patients has not been studied. The aim of this study was to examine the association of serum BTP with mortality in incident hemodialysis participants of the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study.…”

Section: Introductionmentioning

confidence: 99%

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Serum β-Trace Protein and Risk of Mortality in Incident Hemodialysis Patients

Shafi¹,

Parekh²,

Jaar³

et al. 2012

Clinical Journal of the American Society of Nephrology

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Summary Background and objectives Residual kidney function in dialysis patients is associated with better survival, but there are no simple methods for its assessment. β-Trace protein is a novel endogenous filtration marker of kidney function that is not removed during hemodialysis and may serve as a marker for residual kidney function similar to serum creatinine in patients not on dialysis. The objective of this study was to determine the association of serum β-trace protein with mortality in incident hemodialysis patients. Design, setting, participants, & measurements Serum β-trace protein was measured in baseline samples from 503 participants of a national prospective cohort study of incident dialysis patients with enrollment during 1995–1998 and follow-up until 2004. Outcomes were all-cause and cardiovascular disease mortality analyzed using Cox regression adjusted for demographic, clinical, and treatment factors. Results Serum β-trace protein levels were higher in individuals with no urine output compared with individuals with urine output (9.0±3.5 versus 7.6±3.1 mg/L; P<0.001). There were 321 deaths (159 deaths from cardiovascular disease) during follow-up (median=3.3 years). Higher β-trace protein levels were associated with higher risk of mortality. The adjusted hazard ratio and 95% confidence interval for all-cause mortality per doubling of serum β-trace protein was 1.36 (1.09–1.69). The adjusted hazard ratios (95% confidence intervals) for all-cause mortality in the middle and highest tertiles compared with the lowest tertile were 0.95 (0.69–1.32) and 1.72 (1.25–2.37). Similar results were noted for cardiovascular disease mortality. Conclusions The serum level of β-trace protein is an independent predictor of death and cardiovascular disease mortality in incident hemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum β-Trace Protein and Risk of Mortality in Incident Hemodialysis Patients

Shafi¹,

Parekh²,

Jaar³

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…9,10 b trace protein (BTP) has recently emerged as another alternative filtration marker. [11][12][13][14][15] BTP is a low molecular weight glycoprotein that is freely filtered by the glomerulus, and has minimal nonkidney elimination. 14 Some studies have suggested that BTP is more accurate than creatinine in estimating measured GFR 11,[13][14][15][16][17][18][19][20][21] and is more strongly associated with CVD.…”

mentioning

confidence: 99%

Filtration Markers May Have Prognostic Value Independent of Glomerular Filtration Rate

Tangri

Inker

Tighiouart

et al. 2012

Journal of the American Society of Nephrology

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Serum levels of creatinine, cystatin C, or b trace protein allow estimation of GFR, but whether these markers contribute additional prognostic information beyond that reflected in GFR is unknown. Here, we analyzed data from the Modification of Diet in Renal Disease study, which provided baseline levels of these markers for 816 participants with a median follow-up of 16.6 years. We examined associations between the reciprocals of these filtration markers and 125 I iothalamate GFR, expressed per SD, with kidney failure and mortality. In univariate analysis, lower GFR and higher levels of each filtration marker associated with a higher risk for all outcomes. After adjustment for GFR in a Cox proportional hazards model, higher creatinine associated with a higher risk for kidney failure but a lower risk for all-cause mortality. Higher cystatin C and b trace protein associated with a higher risk for both kidney failure and all-cause mortality. In models including either cystatin C or b trace protein, the association of GFR with all-cause mortality was no longer significant after the addition of the filtration marker, suggesting the possibility of multicollinearity. In summary, after adjustment for GFR, levels of creatinine, cystatin C, and b trace protein, each remained directly associated with kidney failure but differed with respect to their associations with mortality. These differences may be a result of non-GFR-related associations of filtration markers, residual confounding by GFR, or collinearity between the filtration markers and GFR. b trace protein and cystatin C seem to provide more consistent prognostic information than creatinine.

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