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.
Ref:
http://www.ncbi.nlm.nih.gov/pubmed/21411200
Showing posts with label rifle criteria. Show all posts
Showing posts with label rifle criteria. Show all posts
Wednesday, June 15, 2011
Wednesday, May 4, 2011
NKF 2011 Live: First Clinical Guidelines on Acute Kidney Injury Issued
This is a summery of one of the talks at The NKF meeting ; MEdscape nephrology conducted an interview with Dr. Kellum who co-chaired the KDIGO initiative.
Go to the link above for the full interview: here are some points of the talk
RIFLE and AKIN should be used by frontline practitioners to diagnose AKI, and this should serve to increase awareness about the prevention, recognition, and management of acute kidney injury.
Up to 33% of ICU patients and as many as 20% of all hospitalized patients develop acute kidney injury. even mild injury, resulting in small changes in renal function acutely, can have significant short-term and long-term consequences.
Replacement fluid should be crystolloids and colloids(avoid albumin, hetastarch and alike).
CIN prophylaxis: Normal saline or bicarbonate are both of equally effective with no preference.
Citracate bath and US-guided catheter insertion were strongly recommended. this maybe controversial the committee admitted.
More in the full interview.
http://www.medscape.com/viewarticle/741856?src=mp&spon=44
Ezra Hazzan MD
Go to the link above for the full interview: here are some points of the talk
RIFLE and AKIN should be used by frontline practitioners to diagnose AKI, and this should serve to increase awareness about the prevention, recognition, and management of acute kidney injury.
Up to 33% of ICU patients and as many as 20% of all hospitalized patients develop acute kidney injury. even mild injury, resulting in small changes in renal function acutely, can have significant short-term and long-term consequences.
Replacement fluid should be crystolloids and colloids(avoid albumin, hetastarch and alike).
CIN prophylaxis: Normal saline or bicarbonate are both of equally effective with no preference.
Citracate bath and US-guided catheter insertion were strongly recommended. this maybe controversial the committee admitted.
More in the full interview.
http://www.medscape.com/viewarticle/741856?src=mp&spon=44
Ezra Hazzan MD
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