β-Trace protein in hemodialysis – comparison of different therapy modalities and high flux dialyzers

Schwab, Sebastian; Bös, Dominik; Hundt, Felix; Kleine, Carola Ellen; Strassburg, Christian P.; Woitas, Rainer P.

doi:10.1515/cclm-2018-0178

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…In our study, the acute effect of a high‐flux HD or HDF session on serum LMWP was associated with good removal of both B2M (69.7% and 82.3% for high‐flux HD and HDF, respectively) and CYSC (66.0% and 77.4% for HF‐HD and HDF, respectively) comparable to previous studies, with a greater removal of BTP (17.5% and 49.3% for high‐flux HD and HDF, respectively). Conflicting results have been published regarding BTP removal by HD . The removal pattern of the three molecules studied here is comparable to that described by Donadio et al in high‐flux HD and by Lindström et al in HDF .…”

Section: Discussionsupporting

confidence: 73%

“…BTP is a heterogeneous monomeric glycoprotein with multiple isoforms which are the result of posttranslational N‐glycosylation leading to molecular weight between 23 and 29 kDa . Conflicting data have been reported regarding removal of BTP during HD or HDF . In addition, to the best of our knowledge, to date no data on BTP removal with PD have been published.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of residual renal function using beta‐trace protein: Impact of dialysis procedures

et al. 2020

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Beta-trace protein (BTP), a low molecular weight protein of 23-29 kDa, has been proposed as a promising biomarker to estimate residual renal function (RRF) in patients on maintenance hemodialysis (HD). Indeed, BTP is cleared by native kidney but not during conventional HD session. By contrast, the removal rate of BTP using convective processes (mainly hemodiafiltration [HDF]) and peritoneal dialysis (PD) has been little or not investigated. Therefore, an aim of this study was to evaluate the impact of dialysis procedures (high-flux HD, on-line post-dilution HDF and PD) on BTP removal in comparison with beta-2 microglobulin (B2M) and cystatin C (CYSC) removals after a single session. In addition, the ability of BTP to predict RRF in PD was assessed.This observational cross-sectional study included a total of 82 stable chronic kidney disease patients, 53 patients were on maintenance dialysis (with n = 26 in HD and n = 27 in HDF) and 29 were on PD. Serum concentrations of BTP, B2M, and CYSC were measured (a) before and after a single dialysis session in HD and HDF anuric patients to calculate reduction percentages, (b) in serum, 24-hour-dialysate and 24-hour-urine in PD patients to compute total, peritoneal, and urinary clearance. RRF was estimated using four equations developed for dialysis patients without urine collection and compared to the mean of the urea and creatinine clearances in PD. The concentrations of the three studied molecules were significantly reduced (P < .001) after dialysis session with significantly higher reduction ratio using HDF compared to HD modality (P < .001):BTP 49.3% vs 17.5%; B2M 82.3% vs 69.7%; CYSC 77.4% vs 66% in HDF and HD, respectively. In non-anuric PD patients, B2M and CYSC were partly removed by peritoneal clearance (72.3% and 57.6% for B2M and CYSC, respectively). By contrast, BTP removal by the peritoneum was negligible and a low bias for the BTP-based equation to estimate RRF (−1.4 mL/min/1.73 m 2 ) was calculated. BTP is significantly removed by high-flux HD or HDF, thereby compromising its use to estimate RRF. By contrast, BTP appears as a promising biomarker to estimate RRF in PD patients since it is not affected by peritoneal clearance, unlike B2M and CYSC, and it is well correlated to RRF.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Estimation of residual renal function using beta‐trace protein: Impact of dialysis procedures

et al. 2020

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“…Previous studies as well as our previous work showed that serum BTP concentration is not substantially eliminated by low-or high-flux haemodialysis membranes but only reduced by hemodiafiltration and that BTP might be a valuable marker for residual diuresis in patients undergoing peritoneal dialysis. 18,20,21,30 Some limitations of our study should be noted. We only included waitlisted ESKD patients, which might represent a relatively "healthy subgroup" of ESKD patients.…”

Section: Serum Btp and Survivalmentioning

confidence: 91%

“…17 BTP has also been shown to be a reliable biomarker for the assessment of residual renal function in patients with end-stage renal disease. [18][19][20] ESKD patients being waitlisted for kidney transplantation are likely to spend years on the waiting list before receiving a kidney transplant. Even though renal transplantation in ESKD reduces the risk of cardiovascular complications in comparison to patients remaining on dialysis, the risk remains increased in comparison to the general population.…”

Section: Introductionmentioning

confidence: 99%

“…The known association of BTP with cardiovascular risk as well as its reliability as a marker for residual kidney function due to its poor elimination by various renal replacement therapies 18,21 suggest BTP as a potential serum pre-transplant biomarker to identify patients at a higher risk for major adverse cardiac events (MACE) in the posttransplant period. Therefore, we aimed to determine the association between pre-transplant serum BTP and post-transplant MACE.…”

Section: Introductionmentioning

confidence: 99%

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Pre‐transplant serum Beta Trace Protein indicates risk for post‐transplant major cardiac adverse events

et al. 2022

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Background Beta Trace Protein (BTP) is a biomarker for residual kidney function which has been linked to cardiovascular and all‐cause mortality in haemodialysis patients. Following renal transplantation, recipients remain at increased risk for cardiovascular events compared with the general population. We aimed to determine the relationship of pre‐transplant BTP to major adverse cardiac events (MACE) in patients following kidney transplantation. Methods We included 384 patients with end‐stage renal disease who received a kidney transplant. MACE was defined as myocardial infarction (ST‐segment elevation or non‐ST‐segment elevation, stroke or transient ischemic attack), coronary artery disease requiring intervention or bypass or death for cardiovascular reason. The association between pre‐transplant serum BTP concentration and post‐transplant MACE was evaluated by Kaplan–Meier and Cox regression analyses. Results Post‐transplant MACE occurred in 70/384 patients. Pre‐transplant BTP was significantly higher in patients with post‐transplant MACE (14.36 ± 5.73 mg/l vs. 11.26 ± 5.11 mg/l; p < .01). Next to smoking (HR 1.81), age > 56.38 years (HR 1.97) and pre‐existing coronary heart disease (HR 8.23), BTP above the cut off value of 12.7 mg/l was confirmed as independent risk factor for MACE (HR 2.02, all p < .05). MACE‐free survival inversely correlated with pre‐transplant BTP levels. Conclusions Pre‐transplant serum BTP concentration may identify renal transplant recipients with higher risk of post‐transplant MACE.

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Reduction of low molecular weight proteins under continuous renal replacement therapy in acute renal failure

et al. 2018

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β-Trace protein in hemodialysis – comparison of different therapy modalities and high flux dialyzers

Cited by 4 publications

References 5 publications

Estimation of residual renal function using beta‐trace protein: Impact of dialysis procedures

Estimation of residual renal function using beta‐trace protein: Impact of dialysis procedures

Pre‐transplant serum Beta Trace Protein indicates risk for post‐transplant major cardiac adverse events

Reduction of low molecular weight proteins under continuous renal replacement therapy in acute renal failure

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