Predicting Susceptibility to Kidney Failure
Kidney failure has long been a particularly dangerous condition, in large part because its symptoms often do not show until the disease has progressed beyond the point of treatment. Cincinnati Children's researcher Prasad Devarajan, MD, is working to find a way to predict kidney failure much earlier, before it becomes deadly.
Dr. Devarajan, director of the Division of Nephrology and Hypertension is currently studying the possibility of using a newly identified protein as a biomarker that could predict kidney failure. His recent studies site evidence in favor of using the protein neutrophil gelatinaseassociated lipocalin, or NGAL, as a new predictive biomarker for diagnosing acute renal failure in patients before it occurs.
"Despite major achievements in treating children and adults with kidney failure, little has changed in the last four decades to predict kidney failure early enough before it progresses into a chronic or deadly condition," Dr. Devarajan says.
Five percent of all patients admitted to the hospital and 30-50 percent of those in intensive care units will have kidney failure. In these cases, 50-80 percent of these people will die. The overall incidence of acute renal failure is rising at an alarming rate.
"In current clinical practice, when kidney failure occurs, the diagnosis is unacceptably delayed. Ironically, even tragically, effective preventive and therapeutic measures are widely available but rarely administered in a timely manner due to the lack of early biomarkers of kidney failure," Dr. Devarajan says.
In a study recently published in the journal Lancet, Dr. Devarajan and colleagues examined whether NGAL could be used to help identify kidney failure before it was too late. By analyzing the urine and blood samples of patients undergoing cardiopulmonary bypass surgery, the researchers concluded that NGAL was a "sensitive, specific and highly predictive early biomarker for acute renal injury after cardiac surgery."
In addition to surgical patients, the new diagnostic test could benefit a wide range of patients who are susceptible to kidney failure, including those who have experienced stroke, trauma, sepsis, kidney transplantation or adverse reactions to medications.
