Two New Tests To Determine The Future Of Patients With Diseased Kidneys

Two New Tests To Determine The Future Of Patients With Diseased Kidneys.
Researchers have come up with two budding tests that seem better able to vaticinate which patients with dyed in the wool kidney disease are more likely to progress to kidney failure and death. This could help streamline care, getting those patients who privation it most the care they need, while perhaps sparing other patients unnecessary interventions. "The late markers provide us with an opportunity to address kidney disease prior to its panel stage," said Dr Ernesto P Molmenti, vice chairman of surgery and captain of the transplant program at the North Shore-Long Island Jewish Health System in Manhasset, NY - "Such primordial treatment could provide for increased survival, as well as enhanced quality of life".

And "The brute problem right now is the tests we use currently just are not very good at identifying people's progressing to either more advanced kidney bug or end-stage kidney disease, so this has big implications in trying to determine who will progress," said Dr Troy Plumb, interim key of nephrology at the University of Nebraska Medical Center in Omaha. But, he added, "there are affluent to have to be validated clinical trials" before these young tests are introduced into clinical practice.

Both studies will appear in the April 20 issue of the Journal of the American Medical Association, but were released Monday to match with presentations at the World Congress of Nephrology, in Vancouver. Some 23 million community in the United States have chronic kidney disease, which can often forge ahead to kidney failure (making dialysis or a transplant necessary), and even death. But experts have no real good way to predict who will progress to more serious disease or when.

Right now, kidney function, or glomerular filtration rank (GFR), is based on measuring blood levels of creatinine, a unproductive product that is normally removed from the body by the kidneys. The first set of study authors, from the San Francisco VA Medical Center, added two other measurements to the mix: GFR regulated by cystatin C, a protein also eliminated from the body by the kidneys; and albuminuria, or too much protein in the urine.

They then compared the three markers together with the informed level of creatinine-based GFR alone. Indeed, combining the three markers more accurately predicted which of 26643 patients were more qualified to progress to kidney failure and death.

The next best predictor for end-stage renal blight was cystatin C plus albuminuria. And, in fact, various organizations have already been lobbying for different guidelines that would add albuminuria to testing protocols. The current familiar was introduced in 2002.

For the second study, researchers from Tufts Medical Center in Boston combined information from several commonplace lab tests to come up with a model that accurately predicted the short-term risk of kidney bankruptcy (needing dialysis or a transplant) in people who already had moderate-to-severe kidney disease. Overall, the examine was developed and confirmed in two groups of Canadian patients totaling nearly 8500 men and women with kidney disease.

A standard that took into account the eight variables - age, sex, estimated GFR, albuminuria as well as blood levels of calcium, phosphate, bicarbonate and albumin - was more correct than a four-factor model, which only took into worth age, sex, GFR and albuminuria. The authors were ruffled enough by the findings that they have already developed an online calculator and smart phone application so doctors can use the nonpareil in practice, said study author Dr Navdeep Tangri.

So "These are lab tests that are nonchalant on every doctor's visit, so it's broadly applicable," he said. "We're gearing up for wider use". But, an accompanying position statement urged caution in immediately implementing the tests without further validation buy rx world. Plumb also notorious that the test developed by Tangri's team would be easier to implement because it relies on regularly done tests, while a cystatin C assay is not readily available and usually needs to be sent out for analysis.