Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
Washington, DC (May 10, 2012) - An inexpensive and widely used urine dipstick test may provide an easier, more effective way to predict Acute Kidney Injury (AKI) in patients with sepsis, or severe blood poisoning infections. This research is presented at the National Kidney Foundation’s Spring Clinical Meetings held here this week.
Researchers led by Javier Neyra, MD at the Henry Ford Hospital in Detroit, Michigan, have found a new prognostic application for a commonly- used diagnostic tool, the dipstick proteinuria (DP) urine test. Intensivists and emergency room physicians have been using it as part of routine testing and admission.
This study, which examined 328 septic patients with no recent history of protein in the urine, found that the detection of this protein via dipstick at admission accurately predicted AKI in 55% of septic patients who were ultimately diagnosed with AKI. AKI occurs in almost 30% of patients with severe sepsis and the presence of albuminuria, or elevated protein in the urine, occurs in nearly 87% of septic patients. Using the DP test resulted in fewer false positives and accurate detection of more severe AKI.
“Production of creatinine from the muscle is reduced in septic patients so relying on changes in serum creatinine to diagnose AKI in such settings could delay its diagnosis. As such, it’s highly important to identify biomarkers that are sensitive, specific, and which enable early diagnosis before substantial kidney damage has been done. Additionally, septic patients receive aggressive IV fluid administration which can further dilute serum creatinine, making it harder to detect AKI in this population,” said Dr. Neyra.
“Ultimately, using this tool to indicate who is most susceptible to AKI may allow providers to intervene early and prevent it from developing. Given the increased risk of developing chronic kidney disease later in life after an episode of AKI, this is especially significant,” said Lynda Szczech, MD, National Kidney Foundation President.
The National Kidney Foundation recently released the first evidence-based clinical practice guidelines for proper detection, diagnosis and treatment of AKI. For more information and to view these guidelines, click here.
The National Kidney Foundation is dedicated to preventing and treating kidney disease, improving the health and well-being of individuals and families affected by these diseases and increasing availability of all organs for transplantation. For more information visit www.kidney.org.