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Báo cáo y học: "N-GAL: Diagnosing AKI as soon as possib"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: N-GAL: Diagnosing AKI as soon as possible. | Available online http ccforum.eom content 11 6 173 Commentary N-GAL Diagnosing AKI as soon as possible Claudio Ronco Department of Nephrology St Bortolo Hospital Vicenza Italy Corresponding author Claudio Ronco cronco@goldnet.it Published 6 November 2007 This article is online at http ccforum.com content 11 6 173 2007 BioMed Central Ltd Critical Care 2007 11 173 doi 10.1186 cc6162 See related research by Zappitelli et al. http ccforum.com content 11 5 R84 Abstract Early diagnosis of acute kidney injury AKI is often problematic due to the lack of suitable early biomarkers of renal damage and kidney function. Neutrophil gelatinase-associated lipocalin NGAL as an early marker of AKI partially overcomes such limitations and seems to demonstrate that diagnosing AKI in its early stages is possible and useful. Using genomic and protein microarray technology a series of molecules have been identified as potential markers for AKI among them NGAL has been demonstrated to rise significantly in patients with AKI but not in the corresponding controls. Furthermore this rise in NGAL occurs in various studies at 24 to 48 hours before the rise in creatinine is observed. NGAL both in urine and plasma is an excellent early marker of AKI with an area under the receiver operator characteristic curve AUC in the range of 0.9. The study of Zappitelli et al. in critically ill children combines for the first time the new RIFLE classification Risk Injury Failure Loss End-stage renal disease of AKI with the validation of NGAL as an early marker of kidney injury. This innovative approach brings a new hope for a timely diagnosis of AKI and thus a timely institution of measures for prevention and protection. The issue of the early diagnosis of acute kidney injury AKI has been debated for years. Partially this has been due to the lack of a suitable and consistent definition. Other limitations are the paucity of available experimental models of AKI and the inadequate capability of selected marker