The National Clinical Director for kidney care Dr O’Donoghue has stated:
Acute Kidney Injury is common and harmful. It is also treatable and avoidable”. Acute kidney injury also costs our NHS a lot of money, about half a billion a year, in fact.1
For the last forty years the laboratory role has traditionally been to provide serum creatinine assay results. However creatinine is a measure of function not damage. Furthermore it takes a couple of days or more to produce a discernible change. Neutrophil Gelatinase-associated Lipocalin (NGAL) on the other hand rises very quickly in both urine and plasma after insult, see graph. Furthermore it is an indicator of kidney damage not function.
AKI happens fast so speedy detection is necessary to ensure that the patient can be properly treated e.g. nephrotoxic drugs can be avoided. Complications leading to worse outcomes and increased length of bed stay can be avoided by early diagnosis and treatment see National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) report “Adding Insult to Injury” 2009. Fast diagnosis and remedial treatment therefore saves the NHS money.
With The NGAL Test™ the laboratory can now play a vital role by informing the clinician of the patient’s NGAL level. This assay, developed by BioPorto, employs a turbidimetric method suitable for open channels on clinical chemistry analysers. It can be used on urine or plasma and results are available in 10 minutes.
This article was published previously in Alpha Laboratories’ Leading Edge Newsletter – Spring 2012.