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

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


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Body Mass Index
  • Creatinine / blood*
  • Cross-Sectional Studies
  • Cystatin C / blood*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / pathology
  • Diagnostic Tests, Routine
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / blood
  • Hypertension / pathology
  • Intramolecular Oxidoreductases / blood*
  • Kidney Function Tests / methods
  • Lipocalins / blood*
  • Male
  • Predictive Value of Tests
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / pathology


  • Biomarkers
  • Cystatin C
  • Lipocalins
  • Creatinine
  • Intramolecular Oxidoreductases
  • prostaglandin R2 D-isomerase