SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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L Risch1 , U Luethi2 , A.R. Huber2

1Department of Internal Medicine, Academic Teaching Hospital, Feldkirch, Austria, 2Department of Laboratory Medicine, Kantonsspital, Aarau, Switzerland

Background: Low molecular weight proteins like cystatin C or beta-2-microglobulin have been described as markers of renal function with better diagnostic characteristics than serum creatinine. Beta-trace protein (prostaglandin D synthase), another low molecular weight protein, has been proposed as a further suitable marker.
Aim: To describe the diagnostic usefulness of serum-beta-trace Protein (sBtp) in detecting impaired renal function in daily clinical routine.
Methods: First, assessment of creatinine clearance (according to the method of Jelliffe) was done in 73 patients (median age 52 years, interquartile range 39-71) from a tertiary hospital covering the whole range of renal function. After determination of serum creatinine (sCr, modified Jaffé method, Dade Behring, US) and sBtp (nephelometric assay, Dade Behring US), correlations were calculated. Further, Passing-Bablok regression analysis and ROC-analysis were done.
Results: Creatinine clearance correlated significantly with sCr (0.92;p < 0.001) and sBtp (0.81; p < 0.001). The equations obtained from Passing Bablok regression analysis were: creatinine clearance = -15.1 + 92.64 x 1/sCr and creatinine clearance= -3.6 + 45.79 x 1/sBtp. According to ROC-analysis, the area under the curve (AUC) of sCr and sBtp in detecting a creatinine clearance < 60 ml/min was 0.98, and, 0.97, respectively (n.s.). In detecting a creatinine clearance < 100 ml/min, the AUC was 0.94 for sCr, and 0.90 for sBtp (n.s).
Conclusions: Reciprocal values of serum beta trace protein concentrations exhibit a significant correlation with creatinine clearance. Serum beta-trace exhibits clinically useful diagnostic characteristics in detecting a creatinine clearance < 60ml/min. However, we were not able to demonstrate superiority to the diagnostic characteristics of the widely used method of serum creatinine determination.

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