Wednesday, June 15, 2011


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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