Two New Tests To Determine The Future Of Patients With Diseased Kidneys
19/12/2013 02:37
Two New Tests To Determine The Future Of Patients With Diseased Kidneys.
Researchers have come up with two unripe tests that seem better able to hint which patients with continuing kidney disease are more likely to progress to kidney failure and death. This could help streamline care, getting those patients who neediness it most the care they need, while perhaps sparing other patients unnecessary interventions. "The unheard of markers provide us with an opportunity to address kidney disease prior to its connection stage," said Dr Ernesto P Molmenti, vice chairman of surgery and the man of the transplant program at the North Shore-Long Island Jewish Health System in Manhasset, NY - "Such initially treatment could provide for increased survival, as well as enhanced quality of life".
And "The basic problem right now is the tests we use currently just are not very good at identifying people's progressing to either more advanced kidney infirmity or end-stage kidney disease, so this has big implications in trying to determine who will progress," said Dr Troy Plumb, interim chieftain of nephrology at the University of Nebraska Medical Center in Omaha. But, he added, "there are effective to have to be validated clinical trials" before these restored tests are introduced into clinical practice.
Both studies will appear in the April 20 issue of the Journal of the American Medical Association, but were released Monday to correspond with presentations at the World Congress of Nephrology, in Vancouver. Some 23 million society in the United States have chronic kidney disease, which can often press on to kidney failure (making dialysis or a transplant necessary), and even death. But experts have no unqualifiedly good way to predict who will progress to more serious disease or when.
Right now, kidney function, or glomerular filtration estimate (GFR), is based on measuring blood levels of creatinine, a vastness product that is normally removed from the body by the kidneys. The first set of study authors, from the San Francisco VA Medical Center, added two other measurements to the mix: GFR precise by cystatin C, a protein also eliminated from the body by the kidneys; and albuminuria, or too much protein in the urine.
They then compared the three markers together with the mainstream labarum of creatinine-based GFR alone. Indeed, combining the three markers more accurately predicted which of 26643 patients were more right to progress to kidney failure and death.
The next best predictor for end-stage renal disorder was cystatin C plus albuminuria. And, in fact, various organizations have already been lobbying for unusual guidelines that would add albuminuria to testing protocols. The current requirement was introduced in 2002.
For the second study, researchers from Tufts Medical Center in Boston combined facts from several commonplace lab tests to come up with a model that accurately predicted the short-term risk of kidney incompetent (needing dialysis or a transplant) in people who already had moderate-to-severe kidney disease. Overall, the check was developed and confirmed in two groups of Canadian patients totaling nearly 8500 men and women with kidney disease.
A design that took into account the eight variables - age, sex, estimated GFR, albuminuria as well as blood levels of calcium, phosphate, bicarbonate and albumin - was more spot on than a four-factor model, which only took into recital age, sex, GFR and albuminuria. The authors were edgy enough by the findings that they have already developed an online calculator and smart phone application so doctors can use the sitter in practice, said study author Dr Navdeep Tangri.
So "These are lab tests that are sedate on every doctor's visit, so it's broadly applicable," he said. "We're gearing up for wider use". But, an accompanying essay urged caution in immediately implementing the tests without further validation esbeltex pills. Plumb also notorious that the test developed by Tangri's team would be easier to implement because it relies on regularly done tests, while a cystatin C study is not readily available and usually needs to be sent out for analysis.
Researchers have come up with two unripe tests that seem better able to hint which patients with continuing kidney disease are more likely to progress to kidney failure and death. This could help streamline care, getting those patients who neediness it most the care they need, while perhaps sparing other patients unnecessary interventions. "The unheard of markers provide us with an opportunity to address kidney disease prior to its connection stage," said Dr Ernesto P Molmenti, vice chairman of surgery and the man of the transplant program at the North Shore-Long Island Jewish Health System in Manhasset, NY - "Such initially treatment could provide for increased survival, as well as enhanced quality of life".
And "The basic problem right now is the tests we use currently just are not very good at identifying people's progressing to either more advanced kidney infirmity or end-stage kidney disease, so this has big implications in trying to determine who will progress," said Dr Troy Plumb, interim chieftain of nephrology at the University of Nebraska Medical Center in Omaha. But, he added, "there are effective to have to be validated clinical trials" before these restored tests are introduced into clinical practice.
Both studies will appear in the April 20 issue of the Journal of the American Medical Association, but were released Monday to correspond with presentations at the World Congress of Nephrology, in Vancouver. Some 23 million society in the United States have chronic kidney disease, which can often press on to kidney failure (making dialysis or a transplant necessary), and even death. But experts have no unqualifiedly good way to predict who will progress to more serious disease or when.
Right now, kidney function, or glomerular filtration estimate (GFR), is based on measuring blood levels of creatinine, a vastness product that is normally removed from the body by the kidneys. The first set of study authors, from the San Francisco VA Medical Center, added two other measurements to the mix: GFR precise by cystatin C, a protein also eliminated from the body by the kidneys; and albuminuria, or too much protein in the urine.
They then compared the three markers together with the mainstream labarum of creatinine-based GFR alone. Indeed, combining the three markers more accurately predicted which of 26643 patients were more right to progress to kidney failure and death.
The next best predictor for end-stage renal disorder was cystatin C plus albuminuria. And, in fact, various organizations have already been lobbying for unusual guidelines that would add albuminuria to testing protocols. The current requirement was introduced in 2002.
For the second study, researchers from Tufts Medical Center in Boston combined facts from several commonplace lab tests to come up with a model that accurately predicted the short-term risk of kidney incompetent (needing dialysis or a transplant) in people who already had moderate-to-severe kidney disease. Overall, the check was developed and confirmed in two groups of Canadian patients totaling nearly 8500 men and women with kidney disease.
A design that took into account the eight variables - age, sex, estimated GFR, albuminuria as well as blood levels of calcium, phosphate, bicarbonate and albumin - was more spot on than a four-factor model, which only took into recital age, sex, GFR and albuminuria. The authors were edgy enough by the findings that they have already developed an online calculator and smart phone application so doctors can use the sitter in practice, said study author Dr Navdeep Tangri.
So "These are lab tests that are sedate on every doctor's visit, so it's broadly applicable," he said. "We're gearing up for wider use". But, an accompanying essay urged caution in immediately implementing the tests without further validation esbeltex pills. Plumb also notorious that the test developed by Tangri's team would be easier to implement because it relies on regularly done tests, while a cystatin C study is not readily available and usually needs to be sent out for analysis.