Research ArticleImaging

Comparison of Cystatin C and β-Trace Protein Versus 99mTc-DTPA Plasma Sampling in Determining Glomerular Filtration Rate in Chronic Renal Disease

Funda Aydin, Evrim Surer Budak, Serkan Demirelli, Ali Ozan Oner, Selen Korkmaz, Gultekin Suleymanlar, Halide Akbas, Fatih Davran and Firat Gungor
Journal of Nuclear Medicine Technology September 2015, 43 (3) 206-213; DOI: https://doi.org/10.2967/jnmt.115.154799

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and cystatin C GFR at confidence level of 95%. sisC = cystatin C.

  • FIGURE 2.
    FIGURE 2.

    Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and β-trace protein GFR at confidence level of 95%. TP2 = β-trace protein.

  • FIGURE 3.
    FIGURE 3.

    (A) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and cystatin C GFR with urinary NAG ≤ 6.1 IU/L, at confidence level of 95%. (B) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and cystatin C GFR with urinary NAG > 6.1 IU/L, at confidence level of 95%. sisC = cystatin C.

  • FIGURE 4.
    FIGURE 4.

    (A) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and β-trace protein GFR with urinary NAG ≤ 6.1 IU/L, at confidence level of 95%. (B) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and β-trace protein GFR with urinary NAG > 6.1 IU/L, at confidence level of 95%. TP2 = β-trace protein.

  • FIGURE 5.
    FIGURE 5.

    (A) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and cystatin C GFR with urinary β2-microglobulin ≤ 0.2 mg/L, at confidence level of 95%. (B) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and cystatin C GFR with urinary β2-microglobulin > 0.2 mg/L, at confidence level of 95%. sisC = cystatin C.

  • FIGURE 6.
    FIGURE 6.

    (A) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and β-trace protein GFR with urinary β2 microglobulin ≤ 0.2 mg/L, at confidence level of 95%. (B) Scatterplot drawn using Bland–Altman analysis showing difference between 99mTc-DTPA GFR and BTP GFR with urinary β2 microglobulin > 0.2 mg/L, at confidence level of 95%. TP2 = β-trace protein.

Tables

  • TABLE 1

    Patient Data

    ParameternMinimumMaximumMean±SD
    TPSM8497231.9114.28
    Urinary β2 microglobulin840.228.22.585.86
    Urinary cystatin C840.231.450.350.29
    Serum β2-microglobulin840.815.76.603.69
    Serum cystatin C840.214.281.920.81
    Serum creatinine831.0279.723.168.58
    Serum sodium84118145135.764.77
    Serum phosphorus842.1532.393.953.19
    Serum blood urea nitrogen841222536.0425.77
    Urinary creatinine841.5795.395.6593.63
    Urinary sodium84819358.7033.32
    Urinary phosphorus842.3169.6327.6516.66
    Urinary total protein841.4578.451.8093.03
    Urinary NAG (IU/L)840.3049.2512.068.57
    β-trace protein (ng/mL)84494,8802,108.51920.57
    Serum FT4840.51.51.240.21
    Thyroid-stimulating hormone840.233.7601.863.71
  • TABLE 2

    Correlation Between TPSM GFR and GFRs Calculated with the Other Methods

    Groupnβ-trace proteinβ2 microglobulinCystatin CCreatinine
    Total89−0.090 (0.417)−0.762 (<0.0001)−0.797 (<0.0001)−0.033 (0.769)
    19−0.200 (0.606)−0.683 (0.042)
    2330.671* (0.000)0.821* (0.000)
    3380.201 (0.227)0.764* (0.000)

    • ↵* Statistically significant.

    • Data are r values followed by P values in parentheses.

  • TABLE 3

    Agreement Between TPSM GFR and Cystatin C and β-Trace Protein GFRs

    ComparisonLimits of agreement*SDMean difference
    Cystatin C and TPSM
     Total−26.5, 3.67.7−11.4
     Group 1−24.8, 6.27.99.3
     Group 2−23.8, 2.36.5−10.8
     Group 3−29.2, 3.38.3−12.9
    β-trace protein and TPSM
     Total−21.4, 23.411.41.0
     Group 1−14.9, 3.24.6−5.9
     Group 2−13.0, 4.84.5−4.1
     Group 3−19.5, 30.912.95.7

    • ↵* 95% confidence interval.

  • TABLE 4

    Correlation Between TPSM GFR and β-Trace Protein and Cystatin C GFRs for the 2 Levels of NAG

    NAG level
    Method≤6.1 IU/L (n = 19)>6.1 IU/L (n = 63)P
    Cystatin C0.957 (<0.0001)0.887 (<0.0001)0.0001
    β-trace protein0.801 (<0.0001)0.694 (<0.0001)0.0001

    • Data are r values followed by P values in parentheses.

  • TABLE 5

    Correlation Between TPSM GFR and β-Trace Protein and Cystatin C GFRs for the 2 Levels of Urinary β2 Microglobulin

    Urinary β2 microglobulin
    Method≤0.2 (mg/L) (n = 19)>0.2 (mg/L) (n = 63)P
    Cystatin C0.892 (<0.0001)0.839 (<0.01)0.0001
    β-trace protein0.626 (<0.0001)0.722 (<0.0001)0.02
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