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Novel Diagnostic Marker for Acute Kidney Injury Previewed at Abbott-Sponsored Scientific Workshop
Date:7/29/2008

new diagnostic biomarker for acute AKI, called urine NGAL (neutrophil gelatinase-associated lipocalin). The protein is produced by the kidney tubules and appears in urine just two to four hours following AKI, up to 46 hours sooner than biomarkers detected by current testing methods.

"The urine NGAL marker has the potential to represent a major advance in identifying patients at risk for developing AKI after surgery or trauma and in other situations commonly seen in critically ill patients," Devarajan said. He noted that delayed diagnosis of AKI with currently-used creatinine tests may prevent physicians from using hydration or blood pressure support in a timely manner to lower the risk for patient harm.

The costs of AKI are a substantial $10 billion a year, mainly from lengthy hospital stays and expensive interventions, according to Chirag Parikh, M.D., Ph.D., associate professor of medicine, Yale University Medical School. "Serum creatinine testing is inadequate. It is a non-specific marker that delays diagnosis of AKI. New biomarkers are needed to stimulate testing of new therapies and significantly decrease the mortality in AKI and costs associated with it," he said.

In his research, Devarajan analyzed urine samples from children with congenital heart defects who had cardiopulmonary bypass surgery. The procedure is a major risk factor for AKI. Half of the children developed AKI, based on results of creatinine tests reported two to three days after surgery. However, their NGAL levels began to increase within a few hours. "Rises in urine NGAL levels at two hours identified 90 percent of children who later developed AKI. Urine NGAL, therefore, was highly predictive of AKI risk, and we found those with higher levels were more likely to die or need dialysis," Devarajan said. He added that these findings have been confirmed in adult populations.

About 65 percent of patients with the highest increase in urine NGAL will require immediate care
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