title: The Reference Intervals for Serum C-Terminal Agrin Fragment in Healthy Individuals and as a Biomarker for Renal Function in Kidney Transplant Recipients.
abstract: BACKGROUND
  C-terminal agrin fragment (CAF) has been shown to be a promising new biomarker for kidney function. The aim of this study was to verify the reference intervals for CAF in Chinese healthy adults and to assess the efficiency of CAF for monitoring renal function after transplantation.
  
  
  METHODS
  Serum samples were collected from 200 healthy adult subjects and 60 living donor kidney recipients before and on day 1, day 2 and at 6 months after transplantation. We measured serum CAF, creatinine, cystatin C and NGAL concentrations at each time. Estimated glomerular filtration rate (eGFR) was evaluated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Reference intervals for CAF were determined at 2.5th and 97.5th percentiles.
  
  
  RESULTS
  Serum CAF concentrations were observed to be higher in females of old age groups while no significant differences were discovered in males between age groups. There were significant gender-related differences in CAF in old age groups (50-64 and ≥65 years). Serum CAF correlated positively with serum creatinine, cystatin C and negatively with eGFR on day 1, day 2 and at 6 months after kidney transplantation. CAF and NGAL fell rapidly into the normal range on the second postoperative day, prior to creatinine and cystatin C.
  
  
  CONCLUSIONS
  This study verified the reference intervals for serum CAF. CAF could be a potential new biomarker for kidney function monitoring.
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Hai-Xia
authors.initials: HX
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Urology, Peking University First Hospital, Beijing, China.
authors.forename: Ze-Wei
authors.initials: ZW
authors.lastname: Ying
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Guo
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Chen-Ying
authors.initials: CY
authors.lastname: Cao
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Yuan-Fang
authors.initials: YF
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
authors.forename: Hui-Rong
authors.initials: HR
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D018171:Agrin / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests / Q000592:standards*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D012016:Reference Values; D066027:Transplant Recipients
chemical_list: D018171:Agrin; D015415:Biomarkers; C000602450:C-terminal agrin fragment; D010446:Peptide Fragments
keywords: C-terminal agrin fragment; kidney transplantation; reference interval