Estimation of residual renal function using beta-trace protein: Impact of dialysis procedures.
Adult
Aged
Aged, 80 and over
Biomarkers
/ analysis
Cross-Sectional Studies
Dialysis Solutions
/ analysis
Female
Glomerular Filtration Rate
/ physiology
Humans
Intramolecular Oxidoreductases
/ analysis
Kidney
/ metabolism
Lipocalins
/ analysis
Male
Middle Aged
Peritoneum
/ metabolism
Renal Dialysis
/ adverse effects
Renal Elimination
/ physiology
Renal Insufficiency, Chronic
/ blood
beta-2 microglobulin
beta-trace protein
conventional hemodialysis
cystatin C
hemodiafiltration
peritoneal dialysis
residual renal function
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
09
10
2019
revised:
07
01
2020
accepted:
07
01
2020
pubmed:
18
1
2020
medline:
5
3
2021
entrez:
18
1
2020
Statut:
ppublish
Résumé
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
Substances chimiques
Biomarkers
0
Dialysis Solutions
0
Lipocalins
0
Intramolecular Oxidoreductases
EC 5.3.-
prostaglandin R2 D-isomerase
EC 5.3.99.2
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
647-654Informations de copyright
© 2020 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
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