Reference ranges for serum β-trace protein in neonates and children younger than 1 year of age

Abstract

Our data provide a BTP reference range for the first year of life. Seeing the biological pattern of BTP, with only a limited postnatal decline, this marker might offer a promising alternative to serum creatinine-based methods for estimating glomerular filtration rate in newborns.

Age‐Dependent Changes of Kidney Injury Biomarkers in Pediatrics

“…KI biomarker values in the healthy pediatric population . Left and right panels illustrate biomarker values retrieved from urine and serum, respectively.…”

“…First, as mentioned before, serum creatinine is an unreliable marker for KI in the pediatric population, and therefore, by applying this correction, possible biomarker trends will be masked. Second, the creatinine excretion is unstable in patients with acute KI; therefore, the changes in biomarker/creatinine ratio cannot be correctly interpreted unless the direct change of each biomarker is known …”

“…It provides the estimated glomerular filtration rate and is based on the child's height and values of serum creatinine, a by‐product of muscle metabolism eliminated through glomerular filtration . Unfortunately, estimated glomerular filtration rate and serum creatinine are both unreliable and inaccurate markers for monitoring of kidney function and detecting KI in pediatric populations for the following reasons: (1) approximately 50% of renal parenchymal loss must occur before serum creatinine changes can be detected; (2) serum creatinine can be influenced by muscle mass variation, nutrition, age, and sex; (3) during the first days of life, serum creatinine rather reflects the maternal kidney function instead of the kidney function of the neonate; (4) overestimation of kidney function is possible in patients with cachexia; and (5) serum creatinine does not allow the exact localization nor the extent of KI …”

“…Although few papers report reference values of various KI biomarkers assessed in a healthy pediatric population, many perform a comparison of KI biomarker values between pediatric patients with kidney diseases, critical ill pediatric patients, and control subgroups . A majority of studies did investigate KI biomarker values in pediatric patients with severe clinical conditions such as acute KI and are compared with controls , patients who did not developed acute KI.…”

“…10 Unfortunately, estimated glomerular filtration rate and serum creatinine are both unreliable and inaccurate markers for monitoring of kidney function and detecting KI in pediatric populations for the following reasons: (1) approximately 50% of renal parenchymal loss must occur before serum creatinine changes can be detected; (2) serum creatinine can be influenced by muscle mass variation, nutrition, age, and sex; (3) during the first days of life, serum creatinine rather reflects the maternal kidney function instead of the kidney function of the neonate; (4) overestimation of kidney function is possible in patients with cachexia; and (5) serum creatinine does not allow the exact localization nor the extent of KI. [11][12][13][14][15][16][17][18][19][20][21][22][23] Understanding Age-Dependent Changes in Pediatrics Kidney function comprises 3 main processes: First, glomerular filtration is responsible for the filtration of the plasma across the glomerular membrane into the renal tubule. Second, tubular excretion transporters can increase the excretion of drug molecules by more actively transport from the plasma into the tubule.…”