Renal failure
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The current Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines advocate creatinine-based equations for estimating GFR to identify patients with potential kidney disease and classify them into different stages due to the fact that serum creatinine is very insensitive to changes in the glomerular filtration rate. Very few biomarkers exist for monitoring chronic kidney disease. The aim of the study was to assess whether NGAL could represent a novel, sensitive marker of kidney function in adult patients with CKD. ⋯ In the healthy volunteers, serum NGAL correlated with age, serum creatinine, eGFR, leukocyte count, and cystatin C. Taking into consideration the fact that the recent DOQI (Dialysis Outcomes Quality Initiative) states that individuals with reduced GRF (glomerular filtration rate) are at greater risk for CVD and cardiac deaths, precise evaluation of renal function is important in order to select the appropriate strategy to reduce the cardiovascular risk. NGAL should be investigated as a potential early and sensitive marker of kidney impairment/injury.
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One hundred and four patients receiving hemodialysis and undergoing anaemia treatment with darbepoetin alfa intravenously once weekly were switched to a biweekly dosing schedule and followed for 24 weeks. The darbepoetin alfa dose was adjusted to maintain the target Hb concentration of 11-14 g/dL. A significant decline in the erythropoiesis-stimulating agent resistance index was observed over the 24-week follow-up, beginning with week 16, whereas the mean dose of darbepoetin alfa did not change significantly after switching to the biweekly dosing schedule. Other factors that might affect resistance to erythropoiesis remained unchanged.