For første gang nogensinde skulle der i USA til sommer komme guidelines for AKI, og følgende link er et sneak peak af hvad det indeholder, der står intet om NGAL, bortset fra dette "The guidelines, which should be published this summer, are aimed at "frontline physicians" and cover everything from defining and diagnosing AKI, the recognition and modification of risk factors, and treatment and follow-up, said Dr. Kellum." -Hvor man så kan håbe at NGAL er nævnt, trods det faktum at FDA endnu ikke har godkendt nogen NGAL test i USA. Og sikkert også derfor at serum creatinin anvendes heri.
http://www.medscape.com/viewarticle/741856
"These guidelines recognize that frontline physicians - not just nephrologists, or intensivists - but emergency room physicians, family practitioners, general internists, radiologists, cardiologists - all the sorts of people that are likely to see these patients early on - really need to be aware of the kinds of things that lead to acute kidney injury and what kinds of things can be done about it."
Og et citat fra vedhæftede PDF, som også er udarbejdet af KDIGO (Kidney Disease Improving Global Outcomes)
"Most of these equations involve the use of creatinine, which is
known to be a late marker in AKI. Instead, maybe drug dosing for patients with AKI needs to take a different approach. There are now more sensitive early biomarkers, such as NGAL, cystatin C, interleukin 18, and kim-1 [16], that could be used in conjunction with the RIFLE [17] and pRIFLE [18] criteria to better predict when to make adjustments in drug therapy regimens."
Alt tyder altså på at KDIGO anvender serum creatinin, for nu, indtil der er foretaget flere studier med nye biomarkører, og alt tyder på at der fortsat er meget stor fokus på de nye biomarkører/Ngal.
Section_topic_summaries.pdf
http://www.medscape.com/viewarticle/741856
"These guidelines recognize that frontline physicians - not just nephrologists, or intensivists - but emergency room physicians, family practitioners, general internists, radiologists, cardiologists - all the sorts of people that are likely to see these patients early on - really need to be aware of the kinds of things that lead to acute kidney injury and what kinds of things can be done about it."
Og et citat fra vedhæftede PDF, som også er udarbejdet af KDIGO (Kidney Disease Improving Global Outcomes)
"Most of these equations involve the use of creatinine, which is
known to be a late marker in AKI. Instead, maybe drug dosing for patients with AKI needs to take a different approach. There are now more sensitive early biomarkers, such as NGAL, cystatin C, interleukin 18, and kim-1 [16], that could be used in conjunction with the RIFLE [17] and pRIFLE [18] criteria to better predict when to make adjustments in drug therapy regimens."
Alt tyder altså på at KDIGO anvender serum creatinin, for nu, indtil der er foretaget flere studier med nye biomarkører, og alt tyder på at der fortsat er meget stor fokus på de nye biomarkører/Ngal.
Section_topic_summaries.pdf
12/5 2011 14:32 fillandkill 0
42393 Hollmen ME et al. - The report on Serum and Urine-neutrophil gelatinase-associated lipocalin (NGAL) levels in deceased donors shows that donor U-NGAL, but not S-NGAL, measurements give added value when evaluating the suitability of a potential deceased kidney donor.
http://www.mdlinx.com/anesthesiology/xml-article.cfm/3590744
Og også for HIV patienter, er der anvendelse:
http://medicine.journalfeeds.com/urology-nephrology/nephrol-dial-transplant/urinary-ngal-is-a-useful-clinical-biomarker-of-hiv-associated-nephropathy/20110511/
http://www.mdlinx.com/anesthesiology/xml-article.cfm/3590744
Og også for HIV patienter, er der anvendelse:
http://medicine.journalfeeds.com/urology-nephrology/nephrol-dial-transplant/urinary-ngal-is-a-useful-clinical-biomarker-of-hiv-associated-nephropathy/20110511/
