most readable about AKI – where are we and what measures can be applied. The article also have a minor section about biomarkers namely NGAL (and associates). quotes:The NGAL gene is one of the earliest and most upregulated genes following ischemic renal injury making it a very sensitive and specific biomarker
But – there is always a but 🙂 – the next quote…:
While Perry et al. demonstrated that an early increase in post-CPB plasma NGAL is asso- ciated with AKI in adult patients undergoing CABG sur- gery, the sensitivity was as low as 38 %. Owing to the lack of sensitivity and specificity of individual biomarkers, it might be prudent to use a panel of biomarkers to categorize the risk for and outcomes from AKI
This is not surprising or down-heartening – this is a result of using the wrong tests. The measurements are not made with “The NGAL-Test” – au contarire. All larger surveys have been using/sponsored either by grossly inaccurate Test (Triage from Alere) or with wrong instructions (Abbott/Architect) where the low cutoff of 150 ng/ml leads to many false positives
it is going to be quite a challenge for the distributors of The NGAL-Test (presently “limited” to Siemens/Roche/IL-Werfen and Wiener) to get general acceptance of The NGAL-Test as the undisputed “numero uno” test it is Cudos to Abbott for pioneering and for having made a household word in the international research and Kidney community through the last years – through sponsoring / co-sponsoring or otherwise supporting hundreds of research articles and surveys. It has meant the World in acceptance and knowledge – unfortunately the wrong cutoff has also meant that there is solid sceptisism of NGAL as a stand -alone marker
In spite of the fact that Roche (as a whole) has not yet decided to ACTIVELY market the
The NGAL-Test (yet) one national company – namely Roche in the Czech republic decided to take things into the own hands – and are helping LabMark (the local BioPorto distributor) in their effort in implementating the test in rouitine-diagnostics. As you may have learned – The Czech Republic have as the first country decided to reimburse the Test (a major and long awaited breakthrough)
One can only hope that France – who I expect to be next in line – decides to take the sane reimbursment strategy as part of including NGAL in routine diagnostics.
