A recent article in AJKD June 2011 issue reviews the up and coming bio markers to replace creatinine in renal injury.
Lets summarize what they have to say:
1. In the differential diagnosis of AKI, currently we use FeNa to help distinguish renal vs pre renal and if need be urinalysis and biopsy. Proposal is to eventually use: IL-18, Kim -1, NgAL, NAG
2. In early detection of renal injury, currently we use crt and GFR, would would help is cystatin C and perhaps GST, IL18, KIM-1, NGAL, NAG and L-FABP.
3. In prognosis, we currently use AKIN and RIFLE criteria based on crt. What might help is cystatin C and above ones as well.
So far, I continue to use only and only one marker, Creatinine- the best marker to date for renal disease; and perhaps proteinuria for progression of kidney disease. I have ordered cystatin C sometimes, but never really helped me clinically. So hoping some of these markers or PANEL of markers might be more helpful than what we currently use in renal disease.
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