engleski

FRACTION EXCRETION OF SODIUM AS A MARKER OF TUBULAR INJURY – IS IT SENSITIVE ENOUGH?

Background. The only promptly avaible testfor early diagnosis of acute kidney failure, so far, is fraction excretion of sodium (FENa). Racent studies indetified neutrophil gelatinase-associated lipocalin (NGAL) as a promising biomarker for such state. The aim of our study was to compare diagnostic usefulness of those analytes in acute tubular impairment caused by bacterial urinary tract infection in children. Methods. We analysed 25 children with static sciantigraphy confirmed diagnosis of acute pyelonephrytis. Serum and urine sodium were measured by ISE, serum creatinine by enzimatic method and urine creatinine by Jaffes method (OLIMPUS AU640, BECKMAN COULTER) in order to calculate FENa. Urine NGAL measurement was performed by CMIA method (ARHITECT i1000, ABBOT). Results. FENa values were in range from 0, 040% to 0, 795%(median 0, 2950), which according to the literature, are all normal values. NGAL values were in range from 17, 9 ng/ml to 1768, 4 ng/ml (median 205, 3) which according to expected normal range of used assay (131, 7) points to acute tubular injury for in 60% of patients. Conclusion. Although FENa is in use as a test for diagnosis of acute renal failure, it is not sensitive enough for detection of minor damage presented in early stage of acute kidney injury. On the other hand, NGAL revealed better sensitivity, and seems to be a better biomarker of minor tubular injury.

acute kidney failure ; biomarker ; Urine NGAL

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