Determination of Clara cell protein urinary elimination as a marker of tubular dysfunction.
Clara cell 16-kDa protein (CC16) is a protein expressed primarily by the bronchial cells. It is rapidly eliminated by glomerular filtration, reabsorbed almost entirely, and catabolized in proximal tubule cells. To date, normal values for urinary CC16 in healthy children have not been determined. We have studied 63 pediatric patients (mean age 8.17 +/- 3.91 years) and 31 healthy children (control group; mean age 8.83 +/- 3.65 years). In the control group, the CC16/creatinine ratio was 1.22 +/- 1.52 microg/g. In 16 out of 31 control children, the value of the ratio was zero. Fourteen patients (22.2%) showed a high CC16/creatinine ratio; in contrast, among these same patients, the ratio N-acetyl-beta-D: -glucosaminidase (NAG)/creatinine was elevated in seven cases (11.1%) and the ratio beta2-microglobulin/creatinine was elevated in seven cases (11.1%). The three parameters were in agreement in 51 patients (80.9%). Among the patients, the CC16/creatinine ratio was correlated with both the beta2-microglobulin/creatinina ratio (r = 0.76, P < 0.001) and the NAG/creatinine ratio (r = 0.6, P < 0.001). Our findings indicate that CC16 is a good marker of proximal tubular function in childhood. The highest observed values were in children with proximal tubulopathies, in children with chronic renal failure, and in those treated with cyclosporine.
Martín-Granado
Ascensión
A
Laboratory Service, Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain.
Vázquez-Moncholí
Carmen
C
Luis-Yanes
María Isabel
MI
López-Méndez
Marisela
M
García-Nieto
Víctor
V
D000118:Acetylglucosaminidase / Q000652:urine; D000293:Adolescent; D015415:Biomarkers / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007674:Kidney Diseases / Q000188:drug therapy / Q000473:pathology / Q000652:urine*; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000473:pathology / Q000652:urine; D007687:Kidney Tubules, Proximal / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D014598:Uteroglobin / Q000652:urine*; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000652:urine
D015415:Biomarkers; D007166:Immunosuppressive Agents; C556389:SCGB1A1 protein, human; D001613:beta 2-Microglobulin; D016572:Cyclosporine; D014598:Uteroglobin; D003404:Creatinine; D000118:Acetylglucosaminidase