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Sci Rep. 2017 Oct 4;7(1):12656. doi: 10.1038/s41598-017-12645-4.

Beta Trace Protein does not outperform Creatinine and Cystatin C in estimating Glomerular Filtration Rate in Older Adults.

Author information

Institute of Public Health, Charité University Medicine, Berlin, Germany.
Institute of Public Health, Charité University Medicine, Berlin, Germany.
Institute of Clinical Epidemiology and Medical Biostatistics, Eberhard Karls University, Tübingen, Germany.
Limbach Laboratory, Heidelberg, Germany.
Department of Nephrology, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Division of Nephrology, Charité University Medicine, Campus Mitte, Berlin, Germany.
Division of Nephrology, Charité University Medicine Campus Benjamin Franklin, Berlin, Germany.


Despite intense research the optimal endogenous biomarker for glomerular filtration rate (GFR) estimation has not been identified yet. We analyzed if ß-trace protein (BTP) improved GFR estimation in elderly. 566 participants aged 70+ from the population-based Berlin Initiative Study were included in a cross-sectional validation study. BTP, standardized creatinine and cystatin C were measured in participants with iohexol clearance measurement as gold standard method for measured GFR (mGFR). In a double logarithmic linear model prediction of mGFR by BTP was assessed. Analyses with BTP only and combined with creatinine and cystatin C were performed. Additionally, performance of GFR estimating equations was compared to mGFR. We found that the combination of all three biomarkers showed the best prediction of mGFR (r2 = 0.83), whereat the combination of creatinine and cystatin C provided only minimally diverging results (r2 = 0.82). Single usage of BTP showed worst prediction (r2 = 0.67) within models with only one biomarker. Subgroup analyses (arterial hypertension, diabetes, body mass index ≤23 and >30) demonstrated a slight additional benefit of including BTP into the prediction model for diabetic, hypertensive and lean patients. Among BTP-containing GFR equations the Inker BTP-based equation showed superior performance. Especially the use of cystatin C renders the addition of BTP unnecessary.

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