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Plasma total C-terminal agrin fragment (tCAF) as a marker for kidney function in patients with chronic kidney disease

  • Dominik Steubl EMAIL logo , Marcel Roos , Stefan Hettwer , Robin Satanovskij , Susanne Tholen , Ming Wen , Christoph Schmaderer , Anna-Lena Hasenau , Peter Luppa , Lynne Stecher , Uwe Heemann and Lutz Renders
Published/Copyright: February 13, 2016
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 9

Abstract

Background:

Total C-terminal agrin fragment (tCAF) is a new biomarker that was previously correlated with kidney function. This article studies the validity of tCAF as a biomarker for kidney function in chronic kidney disease (CKD).

Methods:

Plasma tCAF, serum creatinine (Cr), cystatin C (CyC), blood urea-nitrogen (BUN) concentrations and estimated glomerular filtration rate (eGFR CKD-EPIcrea-cystatin) were assessed in 426 individuals [71 without CKD (CKD 0°) and 355 CKD patients]. In addition to descriptive statistics, univariate correlation between tCAF and biomarkers/eGFR was calculated; multiple linear regression modeling was applied between logarithmic (log) tCAF and log eGFR and adjusted for demographic data. The same methods were used to analyze the association of demographic factors and the different biomarkers adjusted for eGFR.

Results:

Mean tCAF levels were 1012.2±789.9 pM. tCAF correlated with all biomarkers/eGFR in univariate analysis (eGFR: r=–0.77, Cr: r=0.74, BUN: r=0.66, CyC: r=0.75). Linear regression modeling revealed an excellent coefficient estimate between log tCAF and log eGFR (CKD-EPIcrea-cystatin) (–0.91, p<0.001). tCAF was the parameter least associated with demographic parameters in both univariate and multivariate regression modeling (only with age, coefficient estimate r=–0.159, p=0.001 in multivariate regression).

Conclusions:

In conclusion, tCAF is a promising biomarker for the assessment of kidney function in CKD patients showing an excellent correlation with eGFR and being less influenced by demographic parameters compared to conventional biomarkers. These preliminary results encourage further evaluation of tCAF in larger CKD cohorts and other clinical settings such as acute renal failure.

Keywords: biomarker; chronic kidney disease; C-terminal-agrin-fragment; glomerular filtration rate
Corresponding author: Dominik Steubl, Dr. med., Department of Nephrology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany, Phone: +49-89-4140-2231, Fax: +49-89-4140-4878, E-mail:
aDominik Steubl and Marcel Roos contributed equally to the work.

Acknowledgments

We thank Dr. Paul Albert, PhD, University of Ottawa for the revision of the manuscript.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: One of the co-authors, Stefan Hettwer, was employed by Neurotune AG, Schlieren, Switzerland in earlier times. All other authors do not have any conflicts of interest to declare.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-10-21
Accepted: 2016-1-2
Published Online: 2016-2-13
Published in Print: 2016-9-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2015-1027
Keywords for this article
biomarker; chronic kidney disease; C-terminal-agrin-fragment; glomerular filtration rate

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. The Theranos phenomenon, scientific transparency and freedom of speech
  4. Holotranscobalamin: in the middle of difficultly lies opportunity
  5. Review
  6. Laboratory and clinical risk assessment to treat myelodysplatic syndromes
  7. Mini Review
  8. Quantitative nucleic acid amplification by digital PCR for clinical viral diagnostics
  9. Genetics and Molecular Diagnostics
  10. Hybrid minigene splicing assay verified the pathogenicity of a novel splice site variant in the dystrophin gene of a Chinese patient with typical Duchenne muscular dystrophy phenotype
  11. General Clinical Chemistry and Laboratory Medicine
  12. Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension
  13. Sex steroid hormone stability in serum tubes with and without separator gels
  14. Reduced absorption and enhanced synthesis of cholesterol in patients with cystic fibrosis: a preliminary study of plasma sterols
  15. An International Standard for holotranscobalamin (holoTC): international collaborative study to assign a holoTC value to the International Standard for vitamin B12 and serum folate
  16. A technical and clinical evaluation of a new assay for inhibin A and its use in second trimester Down syndrome screening
  17. Investigation on the ability of first trimester glycodelin and angiopoietin-2 to predict small-for-gestational age pregnancies at delivery
  18. Plasma total C-terminal agrin fragment (tCAF) as a marker for kidney function in patients with chronic kidney disease
  19. Hematology and Coagulation
  20. Thirty-minutes’ exposure to smartphone call triggers neutrophil activation in vitro
  21. Performance of the XN-2000 WPC channel-flagging to differentiate reactive and neoplastic leukocytosis
  22. Differences in lupus anticoagulant final conclusion through clotting time or Rosner index for mixing test interpretation
  23. Reference Values and Biological Variations
  24. Derivation of level-specific reference change values (RCV) from a health screening database and optimization of their thresholds based on clinical utility
  25. Cancer Diagnosis
  26. BRAF analysis before surgery for papillary thyroid carcinoma: correlation with clinicopathological features and prognosis in a single-institution prospective experience
  27. Letters to the Editor
  28. Significant increase of serum prostate-specific antigen after exercise
  29. Serum delipidation but not high-speed centrifugation is effective in clearing lipemia interference in serum lipase activity measurement
  30. A relationship between absolute monocyte count and C-reactive protein in patients with migraine undergoing no pharmacological therapy
  31. Validation of the “Vacutainer® urinalysis preservative plus urine tube” for the determination of albumin and protein
  32. Performance evaluation of a novel automated HIV Ag/Ab chemiluminescence immunoassay
  33. SLC26A4 genotypes associated with enlarged vestibular aqueduct malformation in south Italian children with sensorineural hearing loss
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