PMID- 22952928
OWN - NLM
STAT- MEDLINE
DCOM- 20130207
LR  - 20211203
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 8
DP  - 2012
TI  - Estimated glomerular filtration rate is a poor predictor of the concentration of 
      middle molecular weight uremic solutes in chronic kidney disease.
PG  - e44201
LID - 10.1371/journal.pone.0044201 [doi]
LID - e44201
AB  - BACKGROUND: Uremic solute concentration increases as Glomerular Filtration Rate 
      (GFR) declines. Weak associations were demonstrated between estimated GFR (eGFR) 
      and the concentrations of several small water-soluble and protein-bound uremic 
      solutes (MW<500 Da). Since also middle molecular weight proteins have been 
      associated with mortality and cardiovascular damage in Chronic Kidney Disease 
      (CKD), we investigated the association between several eGFR formulae and the 
      concentration of Low Molecular Weight Proteins (LMWP) (MW>500 Da). MATERIALS AND 
      METHODS: In 95 CKD-patients (CKD-stage 2-5 not on dialysis), associations between 
      different eGFR-formulae (creatinine, Cystatin C-based or both) and the natural 
      logarithm of the concentration of several LMWP's were analyzed: i.e. parathyroid 
      hormone (PTH), Cystatin C (CystC), interleukin-6 (IL-6), tumor necrosis 
      factor-alpha (TNF-alpha), leptin, retinol binding protein (RbP), immunoglobin light 
      chains kappa and lambda (Ig-kappa and Ig-lambda), beta-2-microglobulin (beta(2)M), myoglobin 
      and fibroblast growth factor-23 (FGF-23)). RESULTS: The regression coefficients 
      (R(2)) between eGFR, based on the CKD-EPI-Crea-CystC-formula as reference, and 
      the examined LMWP's could be divided into three groups. Most of the LMWP's 
      associated weakly (R(2) <0.2) (FGF-23, leptin, IL-6, TNF-alpha, Ig-kappa, Ig-lambda) or 
      intermediately (R(2) 0.2-0.7) (RbP, myoglobin, PTH). Only beta(2)M and CystC showed 
      a strong association (R(2) >0.7). Almost identical R(2)-values were found per 
      LMWP for all eGFR-formulae, with exception of CystC and beta(2)M which showed weaker 
      associations with creatinine-based than with CystC-based eGFR. CONCLUSION: The 
      association between eGFR and the concentration of several LMWP's is inconsistent, 
      with in general low R(2)-values. Thus, the use of eGFR to evaluate kidney 
      function does not reflect the concentration of several LMWP's with proven toxic 
      impact in CKD.
FAU - Neirynck, Nathalie
AU  - Neirynck N
AD  - Nephrology Section, Department of Internal Medicine, Ghent University Hospital, 
      Gent, Belgium. n.neirynck@ugent.be
FAU - Eloot, Sunny
AU  - Eloot S
FAU - Glorieux, Griet
AU  - Glorieux G
FAU - Barreto, Daniela V
AU  - Barreto DV
FAU - Barreto, Fellype C
AU  - Barreto FC
FAU - Liabeuf, Sophie
AU  - Liabeuf S
FAU - Lenglet, Aurelie
AU  - Lenglet A
FAU - Lemke, Horst D
AU  - Lemke HD
FAU - Massy, Ziad A
AU  - Massy ZA
FAU - Vanholder, Raymond
AU  - Vanholder R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120831
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (FGF23 protein, human)
RN  - 0 (Toxins, Biological)
RN  - 0 (uremia middle molecule toxins)
RN  - 7Q7P4S7RRE (Fibroblast Growth Factor-23)
SB  - IM
MH  - Aged
MH  - Female
MH  - Fibroblast Growth Factor-23
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Molecular Weight
MH  - Prognosis
MH  - Renal Insufficiency, Chronic/*blood/*physiopathology
MH  - Toxins, Biological/*blood
PMC - PMC3432070
COIS- Competing Interests: DHL is employer at EXcorLab GmbH. This does not alter the 
      authors' adherence to all PLoS ONE policies on sharing data and materials.
EDAT- 2012/09/07 06:00
MHDA- 2013/02/08 06:00
PMCR- 2012/08/31
CRDT- 2012/09/07 06:00
PHST- 2012/04/18 00:00 [received]
PHST- 2012/07/30 00:00 [accepted]
PHST- 2012/09/07 06:00 [entrez]
PHST- 2012/09/07 06:00 [pubmed]
PHST- 2013/02/08 06:00 [medline]
PHST- 2012/08/31 00:00 [pmc-release]
AID - PONE-D-12-11481 [pii]
AID - 10.1371/journal.pone.0044201 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(8):e44201. doi: 10.1371/journal.pone.0044201. Epub 2012 Aug 31.