Assessment of Serum C-Terminal Agrin Fragment in Chronic Kidney Disease Patients

Attia Elsayed, Fatma M.; Mohammed, Ezzat Moustafa; Saeed Shalaby, Sally Mahmoud; Allam, Hala M.; Shokry Sakla, Niveen Shafeek; Metwally Mohammed, Aya Moustafa; Taha, Fatima El Taher

doi:10.21608/zumj.2025.413532.4104

Assessment of Serum C-Terminal Agrin Fragment in Chronic Kidney Disease Patients

Document Type : Original Article

Authors

¹ Lecture of Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt

² Professor of Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt

³ Professor of Biochemistry Department, Faculty of Medicine, Zagazig University, Egypt

⁴ Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt

10.21608/zumj.2025.413532.4104

Abstract

Background: Chronic kidney disease (CKD) is a prevalent and progressive condition associated with significant morbidity and mortality. Early detection is essential for improving patient outcomes. C-terminal Agrin fragment (C-TAF), a degradation product of Agrin, has emerged as a potential biomarker reflecting glomerular and renal injury. Our study aimed to investigate and evaluate serum levels in CKD patients to evaluate its role in early prediction and better management of disease progression. Methods: This case control study was carried out on 85 individuals recruited from the outpatient clinics and inpatient wards of the Department of Nephrology, Zagazig University Hospitals. The participants were divided into two main groups; 17 healthy individuals (Control group) and 68 age- and gender-matched patients with known CKD, further subdivided into four subgroups, each comprising 17 patients, according to their disease stage based on the KDIGO classification (Cases group). Using the Modification of Diet in Renal Disease (MDRD) formula, serum (C-TAF) by ELISA, the estimated glomerular filtration rate (eGFR) was determined for each patient. Results: Compared to healthy controls, CKD patients had significantly higher serum (C-TAF) levels (p<0.001), and these levels increased as CKD stages progressed. The best cutoff value for predicting CKD was ≥207.1pg/ml (AUC=0.898, sensitivity=82.4%, specificity=88.2%).C-TAF showed high diagnostic performance in identifying early-stage CKD, particularly stage 1 at a cutoff ≥124.85 pg/ml (AUC=0.73,sensitivity=100%).Conclusion: that C-TAF level increased with progression of kidney impairment stages so it could serve as a promising non-invasive biomarker for prediction of progression of CKD, potentially aiding in diagnosis and management of the disease.

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