Children's Hospital researchers: Test can identify severe kidney problems earlier

A simple laboratory test may help doctors make an earlier identification of patients at risk of severe kidney injury after  surgery, say researchers at Children's Hospital Medical Center Cincinnati. And spotting the likelihood of a problem earlier could give doctors a better chance of preventing the problem altogether, they say. The researchers are working to prevent acute kidney injury (AKI), a serious complication that can cause death or permanent loss of kidney function. Doctors at Children's, the University of Cincinnati College of Medicine and elsewhere studied using the test in children undergoing bypass surgery to repair congenital heart defects. One of the major risks of such surgery is acute kidney injury. In fact, 51 percent of the children studied developed AKI, but researchers using the test were able to identify 90 percent who developed it within two hours of surgery. Current practices don't identify the problem until days later, the researchers say in the study, published in the May 2008 issue of the Clinical Journal of the American Society of Nephrology.
 
The test measures a biomarker with the acronym "NGAL" in urine samples. "The availability of an early biomarker like NGAL might enable the timely initiation of interventions," says Dr. Prasad Devarajan of Cincinnati Children's, one of the study authors. Previous studies had linked NGAL levels to the risk of acute kidney injury, but the NGAL test used was not practical for routine use after surgery. The test used in this study, now under development by Abbott Laboratories, requires only a few drops of urine and provides results in 35 minutes. Doctors hope the new test will be a major advance in identifying patients at risk of developing AKI after surgery or trauma.

Writer: David Holthaus
Source: Nick Miller, Cincinnati Children's Hospital Medical Center