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New Tests Could Spot Which Kidney Patients Will Do the Worst
Date:4/11/2011

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 measured 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 current standard of creatinine-based GFR alone.

Indeed, combining the three markers more accurately predicted which of 26,643 patients were more likely to progress to kidney failure and death.

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

For the second study, researchers from Tufts Medical Center in Boston combined data from several commonplace lab tests to come up with a model that accurately predicted the short-term risk of kidney failure (needing dialysis or a transplant) in people who already had moderate-to-severe kidney disease.

Overall, the test was developed and confirmed in two groups of Canadian patients totaling nearly 8,500 men and women with kidney disease.

A model 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 accurate than a four-factor model, which only took into account age, sex, GFR and albuminuria.

The authors were excited enough by the findings that they have already developed an online calculator and smart phone application so doctors can use the model in practice, said study author Dr. Navdeep Tangri.

"These are lab tests that are collected on every doctor's visit, so it's broadly applicable," he said. "We're gearing up for wider use."

But, an accompanying editorial urged caution in immediately implementing the tests without furt
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