ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
|
|
|
Laboratory Assessment Of Renal Functions For The Early Diagnosis Of Kidney Failure
Dr. Tülay KÖKENa
aBiyokimya AD, Afyon Kocatepe Üniversitesi, Tıp Fakültesi, AFYON
Early detection of renal impairment is crucial for the success of preventive treatment. Because patients in early stages of chronic kidney disease often exhibit few signs and symptoms, tests for screening and diagnosis are critical in nephrology.
Estimates of glomerular filtration rate (GFR) are the best overall indices of the level of kidney function. A number of measures for estimating GFR have been devised. İnulin has long been considered an ideal substance to estimate GFR. The urinary clearance of exogenous radioactive markers (125I-iothalamate and 99mTc-DTPA) provide excellent measures of GFR but are not available for routine usage. Plasma clearances of exogenous substances including iohexol and 51Cr-EDTA have been used as well. High pressure liquid chromatography for measurement of non-radiolabeled iothalamate in blood and urine has given promising results. Serum cystatin C has also been used to estimate GFR. The most widely used measures of GFR in clinical practice are based on the 24-hour creatinine clearance or serum creatinine concentration. Since the serum creatinine measurement is associated with serious limitations the use of relevant equations (Cockroft & Gault, MDRD…) has been shown to give more valid estimates. The microalbuminuria test also provides sufficient early evidence of risk for kidney and heart failure, thus prompting preventive action.
The reduction and treatment of chronic degenerative diseases are key priorities for public health systems today. Therefore, screening that allows the early identification of renal impairment and cardiovascular risk is vital and should be considered as part of an integrated approach for the correct diagnosis and suitable treatment of these interrelated diseases.Keywords: Renal failure, glomerular filtration rate (GFR), microalbuminuria, biochemical testsTurkiye Klinikleri J Int Med Sci 2005, 1(38):77-82
|
|
|
|
|
