Beta-Trace Protein as a Potential Marker of Acute Kidney Injury: A Pilot Study.
INTRODUCTION
Acute kidney injury (AKI) is a frequent complication among patients in the intensive care unit (ICU). The limitations of serum Cr (sCr) in timely detecting AKI are well known. Beta-trace protein (BTP) is emerging as a novel endogenous glomerular filtration rate marker. The aim of this study was to explore the role of BTP as a marker of AKI.


METHODS
Patients admitted to the ICU undergoing surgery were included. BTP, sCr, Cystatin C (CysC), and neutrophil gelatinase-associated lipocalin (NGAL) were measured preoperatively, postoperatively (post-op), and at the first (D1) and second (D2) post-op day. AKI was defined as an increase of sCr to ≥1.5-fold from baseline within 2 days after surgery.


RESULTS
Of the 52 patients studied, 10 patients (19%) developed AKI. Patients with AKI were older (69.6 ± 10.7 vs. 58.1 ± 16.7 years, p = 0.043) and had a longer length of ICU stay (13 [IQR 6-49] vs. 6 [IQR 5-8] days, p = 0.032). Between the 2 groups, the evolution of BTP, sCr, CysC, and NGAL over time differed significantly, with overall higher values in the AKI group. ROC analysis for the detection of AKI within 2 days after surgery showed a great accuracy for BTP. The area under the curve (AUC) for BTP post-op; D1; and D2 was, respectively, 0.869 ± 0.049; 0.938 ± 0.035; and 0.943 ± 0.032. The discriminative power of a BTP measurement on D1 was superior in detecting AKI compared to NGAL (adjusted p value = 0.027). We could not detect a significant difference between the AUCs of other biomarkers (NGAL, sCr, and CysC).


CONCLUSION
Serum BTP is a promising marker for diagnosing AKI in ICU patients undergoing surgery.
['Leyssens|Katrien|K|', 'Van Regenmortel|Niels|N|', 'Roelant|Ella|E|', 'Guerti|Khadija|K|', 'Couttenye|Marie Madeleine|MM|', 'Jorens|Philippe G|PG|', 'Verbrugghe|Walter|W|', 'Van Craenenbroeck|Amaryllis H|AH|']
D058186:Acute Kidney Injury D000368:Aged D015415:Biomarkers D005260:Female D006801:Humans D019746:Intramolecular Oxidoreductases D054834:Lipocalins D008297:Male D008875:Middle Aged D010865:Pilot Projects
Beta-trace protein Acute kidney injury Intensive care unit Cystatin C Neutrophil gelatinase-associated lipocalin