Koopmans, L. (Liese) (2015) Acute Kidney Injury and diagnostic performance of Neutrophil Gelatinase-Associated Lipocalin and KidneyInjury Molecule-1 in imported P. falciparum malaria. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
KoopmansL.pdf Restricted to Registered users only Download (1MB) |
Abstract
A dreaded complication of severe malaria is acute kidney injury (AKI), showing poor outcomes and is, in addition, especially seen in non-immune adults with a P. falciparum malaria infection. Early identification of patients developing AKI may improve outcomes. Nowadays, diagnosis of AKI relies on increased serum creatinine. This creatinine-based diagnosis is delayed and unreliable. As with most diseases, the earlier an intervention can be instituted in AKI, the better the outcome. Since creatinine fails to diagnose AKI in the early-damage stage, diagnostic accuracy of novel biomarkers AKI are under intense investigation. Recent findings show that biomarkers, like ‘neutrophil gelatinase-associated lipocalin’ (NGAL) and ‘kidney injury molecule-1’ (KIM-1), are sensitive markers for structural kidney injury and could be used for early diagnosis of AKI. To determine if there are laboratory measurements, other than creatinine, at initial presentation and whether there are associated factors for development of AKI on admission, logistic regression analysis of 485 patients, with the outcome development of AKI, was performed. Furthermore, diagnostic accuracy of laboratory measurements was compared with accuracy of creatinine. Results show that increasing age, low platelet count and leucocytosis are independent associated with development of AKI; moreover none of the laboratory measurements showed significantly better diagnostic accuracy for AKI, compared to serum creatinine. In addition, NGAL & KIM-1 diagnostic performance for AKI is compared to that of creatinine in a pilot study containing 39 patients. Equal diagnostic performance of NGAL & KIM-1 and creatinine is seen, with urine NGAL showing most promising results; but no firm conclusions can be drawn. Larger studies are needed to further analyse diagnostic accuracy of NGAL and KIM-1 for AKI in the P. falciparum population.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty Supervisor: and Rheenen, dr. P.F. van University Medical Center Groningen |
| Supervisor name: | Local Supervisor: and Genderen, dr. P.J. van and Havenziekenhuis /Harbour Hospital Rotterdam |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1124 |
Actions (login required)
 |
View Item |