Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UNIPROT:Q92565 (
GFR
)
4,179
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Alpha-1-microglobulin (alpha-1-m) is a low molecular weight glycoprotein (mw 25-33 KD) that is filtered through the glomeruli and reabsorbed in the proximal parts of the renal tubules where it is catabolized. Normal ranges were established for alpha-1-m (100 healthy controls) in serum (20-42 mg/l) and urine (3.5-8 mg/l). Alpha-1-m was then measured in 341 urine samples whose protein pattern had been classified as "pathologic" and "normal" according to microelectrophoresis. Increased alpha-1-m concentrations were found in 266 out of 280 pathologic urines (5% false negative) and in 3 out of 61 normal urines (4% false positive).
Beta-2-microglobulin
(beta-2-m), total protein or protein test strips showed a poorer correlation to the electrophoretic results. Measurement of alpha-1-m is, therefore, the most sensitive of these methods for the detection of proteinuria. In 90 patients with low molecular weight proteinuria and either with or without renal insufficiency alpha-1-m concentrations were determined in both urine and serum. While all patients had elevated urinary alpha-1-m concentrations, increased serum values were only found in renal insufficiency (Ccrea less than 100 ml/min). Independently of these results, we were also able to establish that increased alpha-1-m levels are found at decreased glomerular filtration rates (Ccrea less than 70 ml/min). Pathologic alpha-1-m concentrations therefore only allow the conclusion of isolated tubular impairment when the
GFR
is greater than 70 ml/min.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Alpha 1-microglobulin in the urine and serum in proteinuria and kidney insufficiency]. 241 44
Creatinine-based glomerular filtration rate estimation (eGFR
cr
) has been improved and refined since the 1970s through both the Modification of Diet in Renal Disease (MDRD) Study equation in 1999 and the CKD Epidemiology Collaboration (CKD-EPI) equation in 2009, with current clinical practice dependent primarily on eGFR for accurate assessment of
GFR
. However, researchers and clinicians have recognized limitations of relying on creatinine as the only filtration marker, which can lead to inaccurate
GFR
estimates in certain populations due to the influence of non-
GFR
determinants of serum or plasma creatinine. Therefore, recent literature has proposed incorporation of multiple serum or plasma filtration markers into
GFR
estimation to improve precision and accuracy and decrease the impact of non-
GFR
determinants for any individual biomarker. To this end, the CKD-EPI combined creatinine-cystatin C equation (eGFR
cr-cys
) was developed in 2012 and demonstrated superior accuracy to equations relying on creatinine or cystatin C alone (eGFR
cr
or eGFR
cys
). Now, the focus has broadened to include additional novel filtration markers to further refine and improve
GFR
estimation.
Beta-2-microglobulin
(
B2M
) and beta-trace-protein (BTP) are two filtration markers with established assays that have been proposed as candidates for improving both
GFR
estimation and risk prediction.
GFR
estimating equations based on
B2M
and BTP have been developed and validated, with the CKD-EPI combined BTP-
B2M
equation (eGFR
BTP-
B2M
) demonstrating similar performance to eGFR and eGFR. Additionally, several studies have demonstrated that both
B2M
and BTP are associated with outcomes in CKD patients, including cardiovascular events, ESRD and mortality. This review will primarily focus on these two biomarkers, and will highlight efforts to identify additional candidate biomarkers through metabolomics-based approaches.
...
PMID:Novel Filtration Markers for GFR Estimation. 2933 47
