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Clin Biochem. 2008 Mar;41(4-5):299-305. Epub 2007 Nov 29.

Beta-trace protein is not superior to cystatin C for the estimation of GFR in patients receiving corticosteroids.

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1
Department of Pediatrics, Vrije Universiteit Medical Center, De Boelelaan 1117, NL-1081 HV, Amsterdam, The Netherlands.

Abstract

OBJECTIVES:

Comparison of the effect of corticosteroid therapy on the diagnostic performance of cystatin C (Cys) and beta-trace protein (bTP), two endogenous markers of GFR.

DESIGN AND METHODS:

Out of a total of 193 pediatric inulin clearance studies, a random sample of 85 steroid-free studies served to establish GFR prediction equations (eGFR), which were used to compare the remaining 76 steroid-free and 32 steroid-positive studies (median prednisone dose 33.0 mg m(-2) day(-1)).

RESULTS:

We found a positive relationship between prednisone dose and eGFR(betaTP) (b=0.414, p=0.0002) and a negative relationship with eGFR(cys) (b=-0.208, p=0.0091). Only Cys independently predicted GFR below 90 mL min(-1) 1.73 m(-2), both in steroid-positives (b=6.260, p=0.010) and steroid-negatives (b=6.845, p=0.012). Glucocorticoid therapy did not affect the accuracy in estimating GFR within 30% of measured GFR for Cys, while accuracy was lower with bTP (65.6% vs. 81.6%, p=0.08).

CONCLUSION:

Glucocorticoids have less impact on the diagnostic accuracy of Cys than bTP.

[Indexed for MEDLINE]

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