Speedy Test May Save Lives

Kidney injury test gives fast results

(RxWiki News) The standard lab test to spot acute kidney injury can take days. A new biomarker test provides diagnosis in only a half hour--a turnaround time that may help save lives.

There is a 25% to 80% percent risk of death from acute kidney injury (AKI). The biomarker test should speed the start of treatment because it provides results in approximately a half hour.

"If blood appears in your urine, call a doctor."

Results of the latest study of urinary biomarkers helps move one biomarker test closer to U.S. federal approval, yet many steps remain. The test is already available outside the U.S.

The new study measured five urinary biomarkers in 1,635 emergency room patients upon their admission to the hospital. All five were elevated in patients with intrinsic AKI (the worst form), says Dr. Thomas Nickolas, assistant professor of clinical medicine at Columbia University medical school in New York City.

A biomarker called uNGAL most accurately diagnosed intrinsic AKI. The biomarker also best predicted intrinsic AKI's duration and severity, the study showed.

A biomarker called Kim-1, together with uNGAL, most accurately predicted death or the need to start dialysis during hospitalization. The test awaiting U.S. approval measures uNGAL.

The current, standard lab test to determine kidney function measures creatinine levels. The test has two major problems: Creatinine levels can remain normal for hours after AKI. Also, an accurate measurement takes 1-3 days.

Combining the creatinine test with urinary biomarkers tests will significantly improve identification of patients at risk of death or dialysis, says Dr. Kai Schmidt-Ott, research group leader at the Max Delbrück Center for Molecular Medicine (Berlin, Germany).

"Identifying these patients at the earliest possible time in the emergency room may enable us to introduce new treatment options to improve their outcomes," she says.

"The use of urinary biomarkers could also be of great use to the military, at disaster sites, and in other situations where quick medical decisions must be made," says Jonathan Barasch, MD, PhD. He is an associate professor of medicine at Columbia University medical school.

The U.S. National Institutes of Health and the German Research Foundation provided major funding for the study. Abbott Laboratories, maker of the uNGAL test, provided some funding.

Dr. Nickolas and colleagues published their observational study online January 9 in the Journal of the American College of Cardiology.

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Review Date: 
January 10, 2012