scholarly journals Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

2014 ◽  
pp. 155 ◽  
Author(s):  
Mary Lynn Davis-Ajami ◽  
Jun Wu ◽  
Katherine Downton ◽  
Emilie Ludeman ◽  
Virginia Noxon
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Utility ◽  
Epoetin Zeta

Clinical utility of urinary liver-type fatty acid binding protein measured by latex-enhanced turbidimetric immunoassay in chronic kidney disease

2016 ◽  
Vol 54 (10) ◽  
Author(s):  
Atsuko Kamijo-Ikemori ◽  
Takeshi Sugaya ◽  
Maki Yoshida ◽  
Seiko Hoshino ◽  
Satoshi Akatsu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Fatty Acid ◽  
Kidney Disease ◽  
Clinical Utility ◽  
Fatty Acid Binding Protein ◽  
Binding Protein ◽  
Assay Method ◽  
Enzyme Linked Immunosorbent Assay ◽  
Fatty Acid Binding ◽  
Acid Binding Protein

AbstractBackground:Urinary liver-type fatty acid binding protein (L-FABP) measured by enzyme-linked immunosorbent assay method (ELISA) was approved as a clinical biomarker of tubular damage by the Japanese Ministry of Health, Labor and Welfare (MHLW) in 2011. We evaluated a new latex-enhanced immunoturbidimetric assay (LTIA) to evaluate the clinical utility of urinary L-FABP measured by LTIA versus an ELISA assay.Methods:LTIA with anti-human L-FABP mouse monoclonal antibodies was performed using an automated clinical chemistry analyzer. Five positive samples with low, medium and high L-FABP concentrations were analyzed to determine the within-run precision. In patients with chronic kidney disease (CKD) (n=91), urinary L-FABP levels were measured by ELISA and LTIA.Results:Measurement of urinary L-FABP revealed urinary L-FABP levels within 30 min. The within-run coefficient of variation was 10.0% for 1.4 ng/mL, 4.4% for 2.5 ng/mL, 3.2% for 9.8 ng/mL, 1.5% for 50.1 ng/mL, and 1.2% for 102.7 ng/mL. Concentrations of urinary L-FABP measured by LTIA were significantly correlated with those measured by ELISA (ρ=0.932). Proportional systematic error was almost within limits of agreement (LOA). Urinary L-FABP levels measured by LTIA were significantly correlated with urinary albumin (ρ=0.634), urinary NAG (ρ=0.688) and eGFR (ρ=–0.561).Conclusions:Measurement of urinary L-FABP by LITA was simple, speedy, and similar in quality to ELISA results. Therefore, this method was approved as external body diagnosing medicines by the Japanese MHLW in 2014. Urinary L-FABP is expected to be widely used in various pathophysiological conditions by measuring urinary L-FABP using LTIA.

scholarly journals A validation study of the kidney failure risk equation in advanced chronic kidney disease according to disease aetiology with evaluation of discrimination, calibration and clinical utility

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ibrahim Ali ◽  
Rosemary L. Donne ◽  
Philip A. Kalra
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Failure ◽  
Clinical Utility ◽  
Predictive Accuracy ◽  
Care Service ◽  
Characteristic Curve ◽  
Risk Equation ◽  
Specific Disease ◽  
Failure Risk

Abstract Background The Kidney Failure Risk Equation (KFRE) predicts the 2- and 5-year risk of end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD) stages 3a-5. Its predictive performance in advanced CKD and in specific disease aetiologies requires further exploration. This study validates the 4- and 8-variable KFREs in an advanced CKD population in the United Kingdom by evaluating discrimination, calibration and clinical utility. Methods Patients enrolled in the Salford Kidney Study who were referred to the Advanced Kidney Care Service (AKCS) clinic at Salford Royal NHS Foundation Trust between 2011 and 2018 were included. The 4- and 8-variable KFREs were calculated on the first AKCS visit and the observed events of ESRD (dialysis or pre-emptive transplantation) within 2- and 5-years were the primary outcome. The area under the receiver operator characteristic curve (AUC) and calibration plots were used to evaluate discrimination and calibration respectively in the whole cohort and in specific disease aetiologies: diabetic nephropathy, hypertensive nephropathy, glomerulonephritis, autosomal dominant polycystic kidney disease (ADPKD) and other diseases. Clinical utility was assessed with decision curve analyses, comparing the net benefit of using the KFREs against estimated glomerular filtration rate (eGFR) cut-offs of < 20 ml/min/1.73m2 and < 15 ml/min/1.73m2 to guide further treatment. Results A total of 743 patients comprised the 2-year analysis and 613 patients were in the 5-year analysis. Discrimination was good in the whole cohort: the 4-variable KFRE had an AUC of 0.796 (95% confidence interval [CI] 0.762–0.831) for predicting ESRD at 2-years and 0.773 (95% CI 0.736–0.810) at 5-years, and there was good-to-excellent discrimination across disease aetiologies. Calibration plots revealed underestimation of risk at 2-years and overestimation of risk at 5-years, especially in high-risk patients. There was, however, underestimation of risk in patients with ADPKD for all KFRE calculations. The predictive accuracy was similar between the 4- and 8-variable KFREs. Finally, compared to eGFR-based thresholds, the KFRE was the optimal tool to guide further care based on decision curve analyses. Conclusions The 4- and 8-variable KFREs demonstrate adequate discrimination and calibration for predicting ESRD in an advanced CKD population and, importantly, can provide better clinical utility than using an eGFR-based strategy to inform decision-making.

scholarly journals The clinical utility and cost impact of cystatin C measurement in the diagnosis and management of chronic kidney disease: A primary care cohort study

PLoS Medicine ◽  
2017 ◽  
Vol 14 (10) ◽  
pp. e1002400 ◽  
Author(s):  
Adam Shardlow ◽  
Natasha J. McIntyre ◽  
Simon D. S. Fraser ◽  
Paul Roderick ◽  
James Raftery ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Cystatin C ◽  
Clinical Utility ◽  
Diagnosis And Management ◽  
Cost Impact

[PS 08-38] CLINICAL UTILITY OF OPTICAL COHERENCE TOMOGRAPHY (OCT) IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD)

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e303
Author(s):  
Craig Balmforth ◽  
Titia Ruys ◽  
James Cameron ◽  
May Hu Khei ◽  
Robert Kimmitt ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Optical Coherence Tomography ◽  
Kidney Disease ◽  
Clinical Utility ◽  
Optical Coherence

scholarly journals The Clinical Utility of SUDOSCAN in Chronic Kidney Disease in Chinese Patients with Type 2 Diabetes

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0134981 ◽  
Author(s):  
Andrea O. Y. Luk ◽  
Wai-Chi Fu ◽  
Xue Li ◽  
Risa Ozaki ◽  
Harriet H. Y. Chung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Utility ◽  
Chinese Patients

CLINICAL UTILITY OF BIOMARKERS IN CHRONIC KIDNEY DISEASE AND CHRONIC HEART FAILURE

2013 ◽  
Vol 39 (3) ◽  
pp. 128-139 ◽  
Author(s):  
Donah Zachariah ◽  
Bartosz Olechowski ◽  
Paul R. Kalra
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Chronic Heart Failure ◽  
Kidney Disease ◽  
Clinical Utility

scholarly journals Erythropoiesis-stimulating agents in patients with chronic kidney disease

2012 ◽  
Vol 3 (2) ◽  
pp. 113
Author(s):  
Mario Eandi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Darbepoetin Alfa ◽  
Administration Route ◽  
Epoetin Alfa ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Erythropoiesis Stimulating Agents ◽  
Economic Issues ◽  
Epoetin Zeta ◽  
Definition Of

Anemia is a frequent complication of chronic kidney disease (CKD) due to the inability of the kidneys to release sufficient erythropoietin to regulate the production of red blood cells. Administration of erythropoiesis-stimulating agents (ESAs) is highly effective in correcting anemia of CKD. The ESAs currently approved in Italy are epoetin alfa, epoetin beta, epoetin theta, darbepoetin alfa, CERA and biosimilars epoetin alfa and epoetin zeta. All the ESAs are effective in correcting renal anemia and increasing hemoglobin levels, but the choice of which to use should also take into account their pharmacokinetics and pharmacodynamics, their administration route, and economic issues. However, regarding the optimal use of ESAs an issue that remains controversial is the most appropriate dose conversion between epoetin alfa and darbepoetin alfa. In fact clinical experience demonstrates that the dose relationship between epoetin alfa and darbepoetin alfa is non proportional across the dosing spectrum. In this review is presented an update on the latest available evidence in the treatment of anemia in CKD patients, with particular reference to the definition of the correct conversion ratio EPO:DARB.

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