The new biomarkers are coming, Thats the good news – and AKI will eventually be tamed – but just how far in the process are we ?
One of our main contributors – writing under the appropriate nick Doctor found this interesting paper – linked to below my remarks:
In short its a resume of a meeeting that has recently taken place in Edinghburg Scotland – where the present state of affairs was discussed:
the preample provides clear evidence as to why AKI is so important – although the knowledge of AKI and the consequences are less well known to the general public, The 12.000 deaths are in the UK alone – on a yearly basis… the 12.000 are not the total of patients experiencing AKI – but those who could be saved if properly managed – with the %ages used in the text – that gives 40.000-60.000 incidents a year…
Acute kidney injury (AKI) is a common, life threatening condition associated with poor outcomes. Current NHS expenditure on AKI and its consequences is greater than for prostate, bowel and lung cancer combined. There is evidence that many patients are not well managed and 20-30% of cases are potentially avoidable. Optimal care could save up to 12,000 lives a year and produce substantial financial savings. Clear clinical guidelines on the early identification and management of patients with AKI will help to inform the effective commissioning of care for these patients.
But according to the group of leading british experts in the Renal Association – there is still some way to go.
The summary states: “It is premature to recommend the use of novel biomarkers of AKI in current clinical practice”
nonetheless the previous Gold Standard (Serum Creatinin) is dismissed as insufficient – quote : “Serum creatinine is an index of glomerular filtration and is therefore not an ideal biomarker for AKI”
Novel markers of early kidney damage are being developed and evaluated, but their exact role in diagnosis and management in AKI remains unproven.
In other words – more trials, more surveyes are to be carried out. As always – unless we have an universually accepted standard of measuring – it is highly unlikely that the test will be applied to routine diagnosis. And – again – This calls for a unique and generally accepted cut-off.
As always – medicoinvestor provides you with the latest and most relevant unbiased info – whether you like it or not 🙂
http://www.rcpe.ac.uk/clinical-standards/standards/uk-consensus-statement-on-management-of-acute-kidney-injury-nov-2012.pdf
