DOI: 10.4103/mjbl.mjbl_264_23 ISSN: 1812-156X

Evaluating BTP, L-FABP, and Salivary Molecular Profiles as Indicators of Renal Injury

Zahraa Khalid Mahmood, Suhayr Aesa Al-Qaysi, Alaa Jafear Mahrath
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Abstract

Background:

Chronic kidney disease (CKD) is rising globally, often progressing to end-stage renal disease (ESRD) with limited therapeutic options.

Objectives:

This study evaluated beta-trace protein (BTP) and liver fatty acid-binding protein (L-FABP) as novel biomarkers for renal dysfunction, alongside standard renal function tests (glucose, urea, creatinine, albumin, total calcium, and ionized calcium). Additionally, we assessed salivary components via attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) spectroscopy for the early detection of kidney abnormalities.

Materials and Methods:

This study included 80 participants: 38 kidney disease (KD) patients (19 CKD and 19 acute kidney injury [AKI]) and 42 healthy controls (aged 18–60 years and body mass index <30 kg/m 2 ). Serum levels of BTP, L-FABP, glucose, urea, creatinine, albumin, ionized, and total calcium were measured, and salivary infrared spectra were analyzed.

Results:

These results showed significantly elevated BTP and L-FABP levels in CKD compared with both AKI and controls (BTP: P < 0.01, test statistic = 21.974; L-FABP: P < 0.01, test statistic = 21.222). ATR-FTIR analysis revealed that the hydroxyl band of salivary carboxyl groups distinguished CKD from controls with 90% sensitivity and 78% specificity (area under the curve [AUC] = 91.1, P = 0.000, cutoff: 3373.20 cm −1 ). It also differentiated CKD from AKI with 94% sensitivity and 64% specificity (AUC = 83.4, P = 0.000, cutoff: 3343 cm −1 ).

Conclusions:

In conclusion, L-FABP is a promising marker for renal disease progression, whereas BTP requires further validation. Notably, salivary ATR-FTIR spectroscopy demonstrates high sensitivity for early renal impairment, offering a noninvasive, rapid diagnostic tool. These findings support integrating novel biomarkers and saliva-based screening into clinical practice for timely intervention in KD.

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