Serum Creatinine as a Potential Biomarker for the Diagnosis of Tuberculous Pleural Effusion

Am J Med Sci. 2021 Feb;361(2):195-201. doi: 10.1016/j.amjms.2020.07.001. Epub 2020 Jul 6.

Abstract

Background: Previous studies have revealed the disadvantages of traditional methods for the diagnosis of tuberculous pleural effusions (TPEs) and have created interest in exploring other effective biomarkers. Many studies have focused on the correlation between pulmonary diseases and serum creatinine (Cr), a representative biomarker of renal function, but little is known about the direct relationship between Cr and TPE. Our study aimed to explore whether Cr can act as a biomarker for the diagnosis of TPE and to evaluate the correlation between Cr and TPE.

Materials and methods: Patients with pleural effusions (PEs) were enrolled in this study. By comparing the concentrations of Cr and adenosine deaminase (ADA) in patients with TPEs and non-TPEs, we determined the sensitivity, specificity, Youden index, and area under the curve for these biomarkers. We generated receiver operating characteristic curves and quantifications to evaluate the diagnostic accuracy.

Results: In total, 86 patients (44 with TPE, 25 with malignant pleural effusion (MPE) and 17 with non-tuberculosis infectious PE (NTIPE)) were enrolled in the study. The concentrations of Cr in TPE were significantly higher than those in non-TPE. However, a similar trend was not observed for NTIPE and MPE. The levels of ADA in TPE were significantly higher than those in NTIPE and MPE.

Conclusion: Cr has the potential for the diagnosis of TPE to some extent though its accuracy is not as good as that of ADA. Further studies are necessary for Cr to be applied in clinical practice for the diagnosis of TPE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Deaminase / blood
  • Aged
  • Creatinine / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pleural Effusion / blood
  • Pleural Effusion / diagnosis*
  • Tuberculosis, Pulmonary / blood
  • Tuberculosis, Pulmonary / diagnosis*

Substances

  • Creatinine
  • Adenosine Deaminase