Biochemical evaluation of beta-trace protein: A newer glomerular filtration biomarker for early detection and risk assessment of chronic kidney disease over the older creatinine.

Objectives

Early detection of chronic kidney disease (CKD) is essential for improving clinical outcomes. However, serum creatinine (Scr), the conventional biomarker for estimating glomerular filtration rate (GFR), has notable limitations, particularly in identifying early-stage CKD. This study evaluates beta-trace protein (BTP) as an alternative biomarker for GFR estimation.

Methods

In this single-center case-control study, serum creatinine (Scr) and serum BTP were measured in 90 patients with CKD and 70 apparently healthy controls. Measured GFR (mGFR) was determined using the 99mTc-DTPA radioisotope clearance technique as the reference standard, and the diagnostic performance of the two biomarkers was compared by receiver operating characteristic (ROC) analysis.

Results

Both Scr and serum BTP levels were significantly elevated in CKD patients compared to the control group. Notably, serum BTP exhibited a stronger inverse correlation with measured GFR (mGFR; r = -0.934) than Scr (r = -0.46), indicating superior sensitivity to renal function decline. Receiver operating characteristic (ROC) curve analysis further demonstrated that BTP had higher diagnostic accuracy, with an optimal cutoff concentration of 0.63 mg/L yielding a sensitivity of 98.9%, specificity of 100%, and area under the curve (AUC) of 0.993. In contrast, Scr at 0.775 mg/dL showed lower diagnostic performance (sensitivity = 83.3%, specificity = 42.9%, AUC = 0.74).

Conclusion

These findings suggest that BTP may offer improved diagnostic precision and earlier detection of CKD compared to Scr, with potential benefits for more accurate GFR estimation and timely clinical intervention.