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Abstract

Acute pancreatitis (AP) belongs to the commonest acute gastrointestinal conditions requiring hospitalization. Acute kidney injury (AKI) often complicates moderately severe and severe AP, leading to increased mortality. Among the laboratory markers proposed for early diagnosis of AKI, few have been studied in AP, including cystatin C and neutrophil gelatinase-associated lipocalin (NGAL). Beta-trace protein (BTP), a low-molecular-weight glycoprotein proposed as an early marker of decreased glomerular filtration, has never been studied in AP. We investigated the diagnostic usefulness of serum BTP for early diagnosis of AKI complicating AP in comparison to previously studied markers. BTP was measured in serum samples collected over the first three days of hospital stay from 73 adult patients admitted within 24 h of mild to severe AP. Thirteen patients (18%) developed AKI in the early phase of AP. Serum BTP was higher in patients who developed AKI, starting from the first day of hospitalization. Strong correlations were observed between BTP and serum cystatin C but not serum or urine NGAL. On admission, BTP positively correlated with endothelial dysfunction. The diagnostic usefulness of BTP for AKI was similar to cystatin C and lower than NGAL. Increased BTP is an early predictor of AKI complicating AP. However, it does not outperform cystatin C or NGAL.

Keywords: acute kidney injury; acute pancreatitis; beta-trace protein; cystatin C; severity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Figure 1

Serum beta-trace protein (BTP) concentrations…

Figure 1

Serum beta-trace protein (BTP) concentrations on day 1 ( A , D ),…

Figure 1 Serum beta-trace protein (BTP) concentrations on day 1 (A,D), 2 (B,E) and 3 (C,F) of hospital stay among patients with AP complicated with acute kidney injury (AKI) diagnosed according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines (A–C) or renal failure (RF) diagnosed according to modified Marshall scoring system (MMSS) (D–F) versus patients without these complications. Data are shown as raw data (points), median (central line), interquartile range (box), and non-outlier range (whiskers).
Figure 2

Figure 2

Serum BTP concentrations on day…

Figure 2

Serum BTP concentrations on day 1 ( A ), 2 ( B )…

Figure 2 Serum BTP concentrations on day 1 (A), 2 (B) and 3 (C) of hospital stay among patients with acute pancreatitis (AP) of various severity (SAP, severe; MSAP, moderately severe; and MAP, mild) diagnosed according to the modified 2012 Atlanta classification. Data are shown as raw data (points), median (central line), interquartile range (box), and non-outlier range (whiskers).
Figure 3

Figure 3

ROC curves showing the diagnostic…

Figure 3

ROC curves showing the diagnostic accuracy of serum BTP ( A ), cystatin…

Figure 3 ROC curves showing the diagnostic accuracy of serum BTP (A), cystatin C (B), urine NGAL (C) and serum NGAL (D) measured at the specified time-points for the diagnosis of AKI. The values of AUC with 95% CI are shown on the graphs; max(48h), maximum value observed during the first two days (or 48 h) of hospital stay.
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