title: Mesothelin and kidney function--analysis of relationship and implications for mesothelioma screening.
abstract: OBJECTIVE
  Malignant mesothelioma (MM) carries a poor prognosis and remains a major public health issue in many countries. Outcomes may be improved with earlier detection and this justifies screening the at-risk asbestos-exposed population. Soluble mesothelin is a potential biomarker for MM, but it has been observed to be elevated in patients with reduced kidney function. Defining the relationship between mesothelin concentrations and kidney function will allow more accurate interpretation of this assay.
  
  
  METHODS
  A cross-sectional study consisting of 144 patients with chronic kidney disease (CKD) was conducted at Sir Charles Gairdner Hospital and Royal Perth Hospital in Western Australia. Only patients with CKD stages II-V were recruited while those with a history of renal transplant, dialysis, or malignancy were excluded. Serum and urine mesothelin and creatinine concentrations were determined.
  
  
  RESULTS
  There were 33, 49, 31 and 31 patients in CKD stages II, III, IV and V, respectively recruited. Serum mesothelin increased significantly with increasing serum creatinine (p<0.0001), and worsening stage of CKD (p<0.0001). A significant correlation between urine mesothelin to creatinine ratio and serum mesothelin concentration was detected (p=0.002). No significant difference was found in urine mesothelin to creatinine ratios across the four CKD stage groups.
  
  
  CONCLUSIONS
  Serum mesothelin concentration is elevated in individuals with renal impairment. Renal function should therefore be taken into account during interpretation of this assay.
authors.affiliation: University of Western Australia, School of Medicine and Pharmacology, Verdun Street, Nedlands, WA 6009, Australia. neil.boudville@uwa.edu.au
authors.forename: Neil
authors.initials: N
authors.lastname: Boudville
authors.forename: Rohan
authors.initials: R
authors.lastname: Paul
authors.forename: Bruce W S
authors.initials: BW
authors.lastname: Robinson
authors.forename: Jenette
authors.initials: J
authors.lastname: Creaney
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D058851:GPI-Linked Proteins / Q000097:blood / Q000652:urine; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008403:Mass Screening; D000090204:Mesothelin; D008654:Mesothelioma / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D003404:Creatinine; D000090204:Mesothelin