Protein marker detects kidney damage in ED
When patients present in an ED with chest pain, blood can be drawn, and the patient's enzyme levels will indicate whether there has been cardiac tissue damage. At present, however, no similar test is available to detect kidney damage.
This status might change soon, based on the results of research conducted in the ED at New York-Presbyterian Hospital/Columbia University Medical Center in New York City, the results of which have been published in the Annals of Internal Medicine.1 Using a urine test to detect the presence of the protein NGAL (neutrophil gelatinase-associated lipocalin) in a trial of 600 ED patients, the researchers found NGAL levels in patients later diagnosed with acute kidney failure were 30 times higher than in patients who did not have renal injury.
"This will need to be validated in a different group of patients in a different setting to make sure there were not any unique factors at play, but if it can be then we have a new tool in the armamentarium that allows us to identify patients suffering from acute kidney injury very early in their course," says James Giglio, MD, chief of emergency medicine at New York — Presbyterian/Columbia.
The most important findings are that NGAL can discriminate acute kidney injury from other forms of kidney problems in the ED, adds Thomas L. Nicholas, MD, MS, assistant professor of clinical medicine at the Columbia University School of Medicine and one of the lead researchers. "It has the potential to actually improve clinical outcomes," he says.
Reference
- Nicholas TL, O'Rourke MJ, Yang J, et al. Sensitivity and specificity of a single emergency department measurement of urinary neutrophil gelatinase-associated lipocalin for diagnosing acute kidney injury. Ann Int Med 2008; 148:810-819.
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