Celebrating World Antimicrobial Awareness week!

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Celebrating World Antimicrobial Awareness week!

It’s World Antimicrobial Awareness week!

Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites resist the effects of medications, making common infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.

Randox want to take part in the global campaign that is celebrated annually to improve awareness and understanding of Antimicrobial. We have interviewed one of our Molecular specialists, Dr Dwaine Vance on how our revolutionary Randox products aid in the fight against AMR.

What threat does AMR present to the health care environment?

In a worse-case scenario the increasingly worrying levels of AMR globally will have a significant negative effect on healthcare. Without effective antimicrobials to treat a wide arrange of infectious diseases, people will be more likely to get ill, be unresponsive to medications, which in turn will result in longer hospital stays, increased economic burden, lower levels of quality of life and ultimately poorer prognosis including elevated levels of morbidity and mortality.

 

How does Randox help in the fight against AMR?

Randox have developed and continue to develop infectious disease tests to detect a wide-range infectious disease. Randox have also included resistance gene markers within these molecular-based PCR tests to determine if an infection is sensitive or resistance to certain antimicrobials.

In addition to diagnostic tests, Randox also supply quality control materials such as third-party molecular controls and external quality assessment schemes that are used in molecular microbiology laboratories to ensure their PCR tests are working accurately and robustly. This means that labs can provide the correct information to clinicians that is vitally important to determine what antibiotic therapy is prescribed to the patient.

 

Can you tell us about any exciting developments in Randox?

Randox are continuously investing and reinvesting in our Molecular Research and Development departments. We have recently released a molecular point of care test that can discriminate between MRSA and MSSA. This means that sufficient isolation and correct primary treatment can be provided to the patient in a timelier fashion. We are in the process of releasing a UTI test that can detect over 20 UTI-related bacterial infections. In addition to these pathogens, this test also determines if the pathogens detected are resistant to commonly used antibiotics such as Trimethoprim or Vancomycin.

Furthermore, Randox are releasing an immunoassay-based point of care machine called the VerasSTAT, which includes tests for CRP and MxA biomarkers. These biomarkers are released into the bloodstream during infection as part of the body’s immune response. CRP and MxA can assist the clinician in determining if an infection is of bacterial or viral origin.

 

What measures do you think we can take to prevent the spread of AMR?

Improved personal hygiene and sanitation will reduce transmission of infectious diseases within the global population. The development of more innovative and more easily accessible antibiotics, as well as improved antibiotic stewardship within clinical settings will also help slow down the alarming rates of AMR globally. Most importantly, the creation of new syndromic style testing panels, like the tests currently provided by Randox will undoubtedly improve the clinical outcome for patients who are have an infectious disease.

We are urging the public to help raise awareness of antimicrobial resistance. Randox is committed to the ongoing development of products and services as well as our research into numerous disease areas to improve health worldwide.

To find out more, visit- www.randox.com or email us- market@randox.com

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Celebrating World Diabetes Day 2022!

Celebrating World Diabetes Day, 14th November 2022!

Diabetes is a serious medical condition that causes blood glucose (sugar) levels to become too high.  This can cause complications such as heart disease, stroke, kidney problems or nerve damage if not treated.

Although there is no cure for Diabetes, the condition can be controlled and monitored.

There are three main types of diabetes, type one, type two and gestational diabetes. The former two are lifelong and can cause life threatening complications if not monitored effectively.

Type one diabetes is when the body can’t make insulin, which is thought to be caused by an autoimmune reaction. In the UK, around 8% of the population have type one.

Type two diabetes is generally caused from lifestyle, when the pancreas doesn’t work properly and can’t keep your blood sugar levels from rising. Type two represents around 90% of people with diabetes in the UK.

Gestational diabetes Mellitus (GDM) is a form of diabetes that appears in pregnancy, characterised by high blood sugar due to the hormones produced in pregnancy. In the UK, around 5% of pregnant women are diagnosed every year.

 

Globally, Diabetes affects more than 415 million people, with type 2 being the most common.

People with T1D have an estimated 50% risk of developing Chronic Kidney Disease over their lifetime. CKD can progress to kidney failure, requiring dialysis or a kidney transplant. Taking a personalized approach to kidney disease screening for people with type 1 diabetes (T1D) may reduce the time that chronic kidney disease (CKD) goes undetected, according to a new analysis performed by the Epidemiology of Diabetes Interventions and Complications study group.

World Diabetes Day aims to increase visibility around the condition and can help sufferers feel less alone. Charities such as Diabetes UK also use the day to help promote awareness and information around the condition to help get people diagnosed earlier through campaigns such as #RewriteTheStory.

 

Randox reagents cover a spectrum of laboratory testing which can help monitor Diabetes and the effectiveness of management. This can help prevent serious complications which can become life threatening.

 

Diagnosis and Monitoring

Fructosamine (Glycated Protein) has been identified as an early indicator of diabetic control compared to other markers such as HbA1c.  HbA1c represents the average blood glucose levels for the previous 2-3 months, conversely fructosamine reflects average blood glucose levels of the previous 2-3 weeks.  HbA1c levels may also be impacted by genetic, haematological and disease-related factors.  The enzymatic Fructosamine method also offers improved specificity and reliability compared to conventional NBT-based methods and does not suffer from non-specific interferences unlike other commercially available Fructosamine assays.

Complications Monitoring – Ketoacidosis

D-3-Hydroxybutyrate (Ranbut) is the most sensitive ketone for the diagnosis of ketosis, in particular diabetic ketoacidosis (DKA) , because it represents approximately 80% of ketones present in blood during DKA. The nitroprusside method commonly used in semi-quantitative dipstick tests only detects acetone and acetoacetate making it less accurate.

Complications Monitoring – Renal Dysfunction

Cystatin C is extremely sensitive to very small changes in GFR and has been identified as a strong predictor of clinical outcomes associated with chronic kidney disease (CKD). Cystatin C doesn’t have a ‘blind area’ like creatinine. Up to 50% of renal function may be lost before significant creatinine elevation occurs. NICE guidelines recommend cystatin C testing due to its higher specificity for significant disease outcomes.

 

To find out more visit: https://www.randox.com/diabetes-reagents/

Or email us at: reagents@randox.com


Acute Kidney Injury

Acute Kidney Injury

Rapid Renal Injury Detection

Multiplex Detection of Acute Kidney Injury from a Single Sample

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    Simultaneous and quantitative detection of multiple kidney function markers from a single patient sample for complete patient profiling
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    Identify early stage renal impairment and ensure earlier intervention. Widely used in drug-related renal clinical trials
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    Unique combination of analytes ensures better sensitivity and accuracy compared to traditional serum creatinine measurement
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    The Randox AKI array measures four qualified FDA urine markers from one sample
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    Multiplex testing better captures reduced renal function, as each biomarker reflects different mechanisms that result in similar injury outputs
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    Utilising patented Biochip Technology, the Randox AKI array is currently available on the Evidence Investigator

Acute kidney injury (AKI) is currently diagnosed using serum creatinine as recommended by the KDIGO guidelines.  Serum creatinine however, has poor sensitivity and specificity for AKI lagging behind both renal injury and recovery.  There is an immediate need for  more sensitive biomarkers to enables earlier identification of AKI, monitor drug toxicity and identify  patients at an increased risk of CKD, end-stage renal disease or long-term kidney dialysis.

The National Institute for Health and Care Excellence (NICE) has highlighted that is important that patients are assessed for AKI on admission to hospital or transfer, monitored for AKI throughout their stay and AKI is managed appropriately if it develops.

Utilising patented Biochip Technology, the Randox Acute Kidney Injury (AKI) array simultaneously tests for four novel biomarkers delivering early diagnosis and monitoring of treatment efficacy  It may also help you conduct safer and faster clinical trials.

Biochip

Randox Acute Kidney Injury (AKI) Array (4-plex)

  • Lipocalin (NGAL)
  • Cystatin C
  • Clusterin
  • Kidney Injury Molecule-1 (KIM-1)

This marker is highly upregulated in kidney tubule cells following nephrotoxic injury severe enough to result in acute renal failure, acute tubular necrosis or acute tubulo-interstitial nephropathy.

Due to its small size and basic pH, Cystatin C is freely filtered by the glomerulus. It is then reabsorbed by tubular epithelial cells and subsequently metabolized. Accumulation of Cystatin C in urine is specific for tubular kidney damage and suggests reduced reabsorption at the proximal tubules as a result of toxicant-induced kidney injury.

Expression of Clusterin is upregulated following a variety of renal injuries and is detectable in urine following acute kidney injury induced by administration of nephrotoxic agents. This occurs before the profound renal transformations that give rise to changes in creatinine and BUN.

KIM-1 is a 30kDa type 1 transmembrane glycoprotein found on actvated CD4+ T cells. It is undetectable in healthy kidney tissue but is expressed at very high levels in proximal tubule epithelial cells in the kidney after toxic injury.

The Evidence Investigator

Meet the Evidence Investigator

The Randox AKI array has been developed for the Evidence Investigator, a semi-automated benchtop immunoassay analyser.

The AKI array would improve patient risk stratification whilst monitoring the effectiveness of treatments & drug toxicity by simultaneously and quantitatively detecting multiple urine biomarkers of kidney damage-related analytes from a single sample.

Evidence Investigator

Want to know more?

Contact us or visit our Investigator Webpage


What Do You Know about Dehydration?

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News       Getting Fit        Eating Healthy

02 August 2019

What do you know about Dehydration?

Dehydration: Do you know the signs?

Dry mouth with thick saliva, headaches, feeling sleepy or irritable, weakness, dizziness made worse when you are standing… sounds like a hangover, right? These are actually all symptoms of early to mild dehydration.

While not a hangover, this can happen from drinking alcohol as it suppresses your production of a hormone called vasopressin. This hormone would normally tell your kidneys to reabsorb water rather than passing it along to your bladder – which explains the ten trips to the bathroom on a night out –  and also makes your hangover worse the next day. Below are a list of dehydration signs to look out for:

 

 

Early or mild dehydration include:

  • Flushed face
  • Extreme thirst or unable to drink
  • Dry, warm skin
  • Can’t pass urine or reduced amounts, dark yellow colour
  • Dizziness, made worse when you are standing
  • Feeling Weak
  • Cramping in the arms and legs
  • Sleepy or irritable
  • Headaches
  • Dry mouth with thick saliva

Moderate to severe dehydration include:

  • Heart failure
  • Low blood pressure
  • Fainting
  • Convulsions
  • Sunken dry eyes
  • Fast but weak pulse
  • Severe muscle contractions in the arms, legs or back
  • Bloated stomach
  • Skin loses its firmness and looks wrinkled
  • Rapid and deep breathing – faster than normal
  • Lack of elasticity of the skin

Are you at risk?

While anyone can become dehydrated, there are certain groups that are particularly at risk such as infants, older people, diabetics and athletes. But what can you do to prevent dehydration? Drink plenty of fluids. Water is the best fluid to drink when dehydrated but also having a non-fizzy, low sugar sports drink will help to replace electrolytes that have been lost. These are minerals the body needs such as chloride, calcium, magnesium, sodium and potassium. Long term dehydration can have serious effects on your health.

 

Randox Health: What We Do

Randox Health packages go beyond a health check. We have the world’s most comprehensive full-body health programmes available on the market today, thanks to Randox Biochips which enable hundreds of individual tests to be carried out from one sample and giving you truly unrivalled knowledge about your health and wellbeing both now and in the future. Our goal is to help you extend your life. Your health matters to us and, above all, we are committed to improving healthcare worldwide by identifying and preventing illness at the earliest possible stage.

 

How we can help you? 

Identifying the very first signs and risks of disease can help prevent health problems that may be on the horizon. Randox Health aim to do this before the appearance of unpleasant symptoms or illness. Prevention is always better than cure. Long-term mild dehydration may have caused damage to your health and our packages tests for up to 350 different biomarkers. Read about our packages here, or contact a member of our team for more information!

Want to know more?

Contact us or visit our Randox Health page to view more.

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Rare Disease Day: 28th February 2019

28th February 2019

Rare Disease Day: 28th February 2019

Rare Disease Day raises awareness of rare diseases and how patients’ lives are affected. Many rare diseases remain incurable and many go undiagnosed. 1 in 20 people will live with a rare disease at some point in their life and this is why it is so important to raise awareness.1

What is a rare disease?

There is no single definition for a rare disease, as many countries identify them differently. In the United States, the Rare Diseases Act of 2002 defines a rare disease by its prevalence: “any disease or condition that affects fewer than 200,000 people in the United States”. However, the EU defines a rare disease as a condition that affects less than 5 in 10,000 of the population. There are approximately 7000 rare diseases and disorders and 50% of people affected by rare diseases are children.2,3

Hyperlipoproteinemia type III

This rare disease day, Randox will be raising awareness of hyperlipoproteinemia type III.  Hyperlipoproteinemia type III, also known as dysbetalipoproteinemia or broad beta disease, is a rare genetic disorder characterised by improper breakdown of lipids, specifically cholesterol and triglycerides.  The condition is caused by mutations in the Apo-E gene, however the inheritance of this condition is complicated due to the development of symptoms having to be triggered by a secondary factor to raise lipid levels. These factors include diabetes, obesity or hypothyroidism.

It is unknown exactly what the prevalence of the condition is, but it is estimated to affect approximately 1 in 5,000 – 10,000 of the general population and it has been found that it affects males more often than females, with women rarely being affected until after menopause.4,5

Figure A. Example of cholesterol and lipid build-up [6] 

Symptoms

Symptoms for hyperlipoproteinemia type III will vary for each individual and some people may even be asymptomatic. The most common symptom is the development of xanthomas which are deposits of fatty material, the lipids, in the skin and underlying tissue. Xanthomas may appear on the palms of the hands, eyelids, soles of the feet or on the tendons of the knees and elbows.

> Chest pain or other signs of coronary artery disease

> Cramps in the calves when walking

> Sores on toes

> Stroke-like symptoms such as trouble speaking, dropping on one side of the face, weakness in an arm or a leg and a loss of balance6

Complications can arise if the condition is left untreated and these can include: myocardial infarction, ischemic stroke, peripheral vascular disease, intermittent claudication and gangrene of the lower extremities.7

Diagnosis

Although there is no specific diagnostic test for hyperlipoproteinemia type III, diagnosis is based on clinical evaluation and identification of symptoms. Research has indicated that an algorithm comprising a number of dysbetalipoproteinemia indices may be helpful in the diagnosis of the disease.  These include:

> Low apolipoprotein B to total cholesterol ratio

> Elevated levels of triglycerides

> Elevated levels of total cholesterol8

Managing the condition

The condition cannot be cured but treatment is to control conditions such as obesity, hypothyroidism and diabetes. Most patients will go through dietary therapy to control their intake of cholesterol and saturated fat. This prevents xanthomas, high levels of lipids in the blood, exercise will also help to lower lipid levels. However, dietary changes may not be effective for some individuals and this is where drugs may be used to lower lipid levels instead.

How Randox can Help

Randox offer a range of routine and niche assays within the lipid testing panel to monitor lipid levels and to identify associated complications.  Some of these tests include:

Apolipoprotein B

The Randox Apolipoprotein B tests utilises an immunoturbidimetric method, offers a wide measuring range and is available liquid ready-to-use for convenience and ease of use.

Learn more about the Randox Apolipoprotein B Test

Total Cholesterol

The Randox Total Cholesterol test utilises the CHOD-PAP method and offers an extensive measuring range with a wide range of kits available to suit a wide range of laboratory sizes.

Learn more about the Randox Total Cholesterol test

Triglycerides

The Randox Triglycerides test utilises the GPO-PAP method while offering an extensive measuring range with both liquid and lyophilised formats available offering choice and flexibility.

Want to know more?

Contact us or download our Cardiology and Lipid Testing brochure to learn more.




Related Products

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Lipid Panel Page

  • References

    [1] Rare Disease Day. What is Rare Disease Day? Rare Disease Day. [Online] 2019. [Cited: February 21, 2019.] https://www.rarediseaseday.org/article/what-is-rare-disease-day

    [2] Genetic Alliance UK. What is a Rare Disease? Rare Disease UK. [Online] 2018. [Cited: February 21, 2019.] https://www.raredisease.org.uk/what-is-a-rare-disease/

    [3] NZORD. Rare Disease Facts and Figures. NZORD. [Online] 2019. [Cited: February 21, 2019.] https://www.nzord.org.nz/helpful-information/rare-disease-facts-and-figures.

    [4] NORD. Hyperlipoproteinemia Type III. NORD. [Online] 2019. [Cited: February 21, 2019.] https://rarediseases.org/rare-diseases/hyperlipoproteinemia-type-iii/

    [5] GARD. Hyperlipidemia Type 3. National Centre for Advanciing Translational Sciences. [Online] December 29, 2016. [Cited: February 21, 2019.] https://rarediseases.info.nih.gov/diseases/6703/hyperlipidemia-type-3

    [6] Falck, Suzanne. Everything you need to know about hyperlipidemia. Medical News Today. [Online] December 21, 2017. [Cited: February 21, 2019.] https://www.medicalnewstoday.com/articles/295385.php

    [7] Medline Plus. Familial Dysbetalipoproteinemia. Medline Plus. [Online] May 16, 2018. [Cited: February 21, 2019.] https://medlineplus.gov/ency/article/000402.htm.

    [8] Dysbetalipoproteinemia: Two cases report and a diagnostic algorithm. Kei, Anastazia, et al. 4, s.l. : World Journal of Clinical Cases, 2015, Vol. 3.


Overcoming the burden of Diabetes and Cardiovascular Disease

The Prevalence 

Cardiovascular disease (CVD) is the number one cause of death globally with more people dying annually from CVD than any other disease state. In 2018, according to the American Heart Association, CVD accounted for nearly 836,546 deaths in the USA (1) with over 17 million known deaths recorded worldwide. It is also proclaimed that around 1.5 million people globally die each year because of diabetes and diabetes related complications. (2) Is there a common link? Can this issue be controlled?

Studies have suggested that diabetes is one of the leading related conditions associated with increased risk of CVD death. A recent study undertaken in 2018 examined the association of many risk factors associated with CVD, the study was broken down by disease state with over 17,000 participants involved. The findings highlighted that 17.9% of these patients suffered from diabetes mellitus and death from a cardiovascular event. (3) Many other pilot and research studies discovered similar findings considering further risk factors such as high blood pressure, abnormal cholesterol and high triglycerides, obesity, lack of exercise and lifestyle choices such as smoking, alcohol and drug abuse. All of which are common with patients who suffer from diabetes, placing them at an increased risk of CVD.

Findings highlighted that over 68% of people aged over 65 living with diabetes die from some form of heart disease with 16% of individuals dying from an ischemic stroke. (4)   The ability to tackle the prevalence of increased death from CVD and diagnosis of diabetes has become a global burden with the international diabetes federation projecting that 592 million people worldwide will have diabetes by 2035. (5)

Worldwide, the increase of diabetes is becoming an economic burden on the patient and healthcare systems mainly due to the direct costs of medical care and the indirect costs of moderated productivity, tied to diabetes and CVD related morbidity and mortality. Many scholars have highlighted economic burden as a primary attribute to both macrovascular and microvascular complications such as coronary artery disease, myocardial infarction, hypertension, peripheral vascular disease, retinopathy, end-stage renal disease and neuropathy. (6)

DID YOU KNOW?

The RX Series offers the worlds largest clinical chemistry test menu

Overcoming the Burden

As CVD is the most prevalent cause of mortality and morbidity in patients with diabetes, effective treatment and analysis is required to control and decrease the number of CVD deaths across the globe. Tackling this issue head on, the Randox RX series introduce Direct HbA1c which refers to glycated haemoglobin which is a product of haemoglobin (a protein which can be found in red blood cells) and glucose from the blood making it glycated.

Testing for HbA1c provides an indication of what an individual’s average blood sugar level has been over recent weeks/months and is generally considered as an indicator of how well the patient is managing and controlling their diabetes. This is significant for those who suffer from diabetes because the higher the levels of HbA1c, the higher the chance of an individual suffering from further diabetes related issues, therefore testing for HbA1c improves the predictions of a CVD event occurring.

The Randox RX series have Direct HbA1c testing capabilities on the RX Daytona +, RX imola and RX modena. Our latex enhanced immunoturbidimetric method which the RX series utilises makes the test simple and quick to perform. The removal of the pre-dilution step removes the risk of human error compromising your results without the need for a separate HbA1c analyser.

Offering the world’s largest test menu, the RX series has an extensive range of cardiac, diabetes and lipid tests with excellent correlation to gold standard methodologies designed to allow laboratories to expand their testing capabilities onto one single platform, providing cost savings through consolidation.

References:

  1. American Heart Association. (2018). Heart Disease and Stroke Statistics 2018 At-a-Glance.Available: https://www.heart.org/-/media/data-import/downloadables/heart-disease-and-stroke-statistics-2018—at-a-glance-ucm_498848.pdf. Last accessed 7th Feb 2019.
  2. World Heart Federation. (2017). Cardiovascular diseases (CVDs) – Global facts and figures.Available: https://www.world-heart-federation.org/resources/cardiovascular-diseases-cvds-global-facts-figures/. Last accessed 7th Feb 2019.
  3. Gomadam, P et al, (2018). Blood pressure indices and cardiovascular disease mortality in persons with or without diabetes mellitus. Journal of Hypertension. 36 (1), 1-5.
  4. Heart attack and stroke symptoms. (2018). Cardiovascular Disease and Diabetes.Available: https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/cardiovascular-disease–diabetes. Last accessed 7th Feb 2019.
  5. Aguiree F, Brown A, Cho NH, Dahlquist G, Dodd S, Dunning T, Hirst M, Hwang C, Magliano D, Patterson C. (2013) IDF Diabetes Atlas.
  6. Bahia LR, Araujo DV, Schaan BD, Dib SA, Negrato CA, Leão MP, Ramos AJ, Forti AC, Gomes MB, Foss MC, Monteiro RA, Sartorelli D, Franco LJ, Value Health. (2011), 137-40.

Obesity and Kidney Disease: What is the Connection?

30th January 2019

Obesity and Kidney Disease: What is the Connection?

The month of January has forever been the month of resolutions with many choosing to ditch the sweets and join the gym. However, for many these efforts are limited to January and bad habits are quick to remerge. Obesity has been a burden on the health service for many years with the problem, like many people’s waist lines, only continuing to expand.

Recent findings have shown that this problem is no longer just increasing in developed countries but also in developing countries. In fact, worldwide obesity has tripled since 1975. In 2016, more than 1.9 million adults were classed as overweight, of which over 650 million were obese.1 These are shocking statistics for a condition that is preventable. As a global concern, it is important to assess all the potential risks of this problem.

The most common diseases associated with obesity are cardiovascular disease (CVD) and diabetes. However, the associated risks are much greater than this. Being overweight may also increase the risk of certain types of cancer, sleep apnea, osteoarthritis, fatty liver disease and kidney disease.2

Obesity is now recognised as a potent risk factor for the development of renal disease.3 Excess weight has a direct impact on the development and progression of chronic kidney disease (CKD). Globally, the prevalence of diabetic kidney disease rose by 39.5% between 2005 and 2015, coinciding with the increased CKD prevalence.4 In obese individuals, the kidneys have to work harder, filtering more blood than normal to meet the metabolic demands of increased body weight, increasing the risk of kidney disease.

The traditional diagnostic test for renal impairment is creatinine. This test is carried out through the measurement of creatinine levels in the blood to assess the kidneys ability to clear creatinine from the body. This is called the creatinine clearance rate which helps to estimate the glomerular filtration rate (GFR), which is the rate of blood flow through the kidneys.5

Problems arise when using creatinine for CKD testing as a number of factors need to be taken into consideration including age, gender, ethnicity and muscle mass. For this reason, black men and women exhibit higher creatinine levels than white men and women, raising concern over the accuracy of this test for certain patient groups.6 In addition, serum creatinine is not an adequate screening test for renal impairment in the elderly due to their decreased muscle mass.7

The main disadvantage of using creatinine to screen for renal impairment is that up to 50% of renal function can be lost before significant creatinine levels become detectable as creatinine is insensitive to small changes in GFR. Consequently, treatment is not provided at the appropriate time which can be fatal, therefore, an earlier and more sensitive marker for renal function is vital.8

These disadvantages have not only been highlighted in research but also by the national institute for health and care excellence (NICE).  NICE updated the classification of CKD in 2004 to include the albumin: creatinine ratio (ACR). They split chronic kidney disease patients into categories based on GFR and ACR. Figure 1 highlights the different categories and risk of adverse outcomes. NICE recommend using eGFR Cystatin C for people in the CKD G3aA1 and higher.9

Figure 1 Classification of Chronic Kidney Disease using GFR and ACR categories.9

Despite these suggestions, Creatinine is still being used for G3a1 and increasing risk levels.

The utility of cystatin C as a diagnostic biomarker for kidney disease has been documented to show superiority of traditional CKD tests. There is no ‘blind area’ making it very sensitive to small changes in GFR and capable of detecting early reductions.  Furthermore, this marker is less influenced by diet or muscle mass and has proven to be a beneficial test in patients who are overweight.8

A number of studies support the statement: ‘Cystatin C levels are higher in overweight and obese patients’. This is important because when cystatin c levels are too high, it may suggest that the kidneys are not functioning properly. One study conducted, using a nationally representative sample of participants, found that overweight and obesity maintained a strong association with elevated serum cystatin C. This suggests that weight can affect the levels of cystatin C and therefore the likelihood of developing kidney disease.10

How Randox can Help

The Randox automated Latex Enhanced Immunoturbidimetric Cystatin C tests offers an improved method for assessing CKD risk, combined with a convenient format for routine clinical use, for the early assessment of at risk patients. Randox is currently one of the only diagnostic manufacturers who offer an automated biochemistry test for Cystatin C measurement, worldwide.

Want to know more?

Contact us or visit our featured reagent page to learn more.




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The move from Nephelometry to Immunoturbidimetric Testing

Background

In clinical diagnostics, proteins are part of a wide range of biochemical markers used to identify health and disease in patient samples. Proteins play a key role in the human body, as they are involved in almost every process and can be associated to functions and regulatory pathways that are either signature for disease onset or a target for therapeutic intervention.

There are two main methods used to detect proteins in patient samples; nephelometry and immunoturbidimetry.  Nephelometry although traditionally thought to be more sensitive can be expensive due to higher consumable costs.  In addition to this nephelometers can be inefficient and are limited by their test menu.  Immunoturbidimetric tests are an increasingly accepted alternative to nephelometry for specific protein assays, and studies have shown a close correlation between Randox immunoturbidimetric tests and nephelometry. This particularly lies with the latex enhanced immunoturbidimetry methodology utilised by Randox.

Why the RX series?

Renowned for quality and reliability, the RX series excels in clinical testing combining robust hardware, intuitive software and a world leading test menu featuring routine and novel high performing reagents.

Running specific protein tests on the RX series provides laboratories with a wide range of advantages. The move from nephelometric testing to immunoturbidimetric lowers laboratory costs as nephelometry requires the use of dedicated instruments which are much slower, have higher consumable costs and require highly trained personnel, with the disadvantage of not being able to perform any other type of assay on a single platform.

The RX series improves laboratory efficiencies not just saving costs but also time. Our range of routine clinical chemistry analysers provide users with flexibility and versatility through consolidation of testing onto one single platform.

DID YOU KNOW?

The RX Series of analysers now welcomes the addition of Direct HbA1c Testing on the RX daytona +, RX imola & RX modena

High Performing and Unique Testing Menu

The RX series of specific protein assays assist in the diagnosis and evaluation of various conditions each with excellent sensitivity and limited inference levels. Randox manufacture immunoturbidimetric kits for the study of a wide range of specific proteins including unique products such as Apolipoprotein C-II, Apolipoprotein C-III, Apolipoprotein E, Cystatin C and Microalbumin.

Most recently the RX series welcomed the addition of Direct HbA1c to our testing panel, available to be run on the RX Daytona +, RX imola and RX modena. If you are interested in running your protein assays on a routine biochemistry analyser, Randox offers a large range of high quality routine and niche protein assays that can be run on most automated analysers.

Click to discover more about our world leading RX series Testing menu or contact us today @theRXseries to find out how we can improve your laboratories testing capabilities.


World Diabetes Day: The Biggest Burden on the NHS

14 November 2018

World Diabetes Day

Diabetes

Approximately 400,000 people in the UK are living with type 1 diabetes, with over 29,000 being children and young people [1]. Type 1 diabetes affects 96% of all children with diabetes in England and Wales, with incidences increasing by approximately 4% each year.

Globally, the UK has the fifth highest rate of type 1 diabetes diagnosis in children (aged up to 14) with 85% of these children having no family history of the condition. Whilst the condition isn’t fatal and can be managed, it cannot be cured. Type 1 diabetes increases the risk of developing other health problems such as heart disease, stroke, foot and circulation problems, sight problems including blindness, nerve damage and kidney problems. However, many of these related conditions are preventable and it is recommended to stabilise blood sugar levels, attend diabetes appointments regularly and complete a diabetes course to educate patients and family members and prevent the risk of further help complications[2].

Diabetes in children

Children under five are at the highest risk of developing diabetic ketoacidosis due to a late diagnosis and it is also thought to be due to of lack of public knowledge of the signs and symptoms attributed to type 1 diabetes. Such symptoms include:

  • Frequent urination as the kidneys are trying to expel excess sugar in the blood, resulting in dehydration which leads to extreme thirst.
  • Increased hunger or unexpected weight loss because the body is unable to attain enough energy from food
  • Slow healing cuts as high blood sugar levels can affect blood flow which can cause nerve damage.
  • Fatigue as the body is unable to convert sugar into energy
  • Irritable behaviour combined with other symptoms can be a means of concern

Diabetes and the NHS

Diabetes costs the NHS approximately £9.8 billion per year, an estimate of 10% of total expenditures. Hospital admissions of children and young people with diabetes presents a considerable burden on themselves, their families and the NHS. It is estimated that approximately 80% of these cases are potentially avoidable.

A report produced by the National Paediatric Diabetes Audit found that although the numbers of admissions didn’t significantly differ year to year, it highlighted differences in terms of socio-economic risk factors:

  • Living in a deprived area increases the risk of hospital admissions which can be attributed to lack of education in the community about diabetic symptoms and the management of diabetes.
  • Children below 5 years of age have a 35% increased risk of hospitalisation compared to those aged 5-9
  • Females have a 33% increased risk of developing type 1 diabetes compared to males.
  • Children with poor diabetes control have a twelve-fold increased risk of hospital admission
  • Insulin pump users have a 27% increased risk of hospital admission compared to those who use insulin injections.
Figure A. Number of preventable paediatric diabetes admissions  [3] 

Prevention

There are campaigns in place to aid in the early diagnosis of type 1 diabetes which mainly focus on raising awareness of the signs and symptoms of diabetes. On this World Diabetes Day, it is important to know that it is not just simply the responsibility of the diabetic patient to prevent admission but the main responsibility lies with the diabetic teams that inform the families with children who are diagnosed with type 1 diabetes.

Paediatric diabetes teams should ensure that the families and the children receive structured education for self-management when diagnosed and throughout the illness. In doing so, the diabetic teams should implement blood ketone testing from diagnosis and utilise the nationally agreed hypoglycaemia management guidelines. It is also important that diabetic teams are fully aware of the patient characteristics associated with a greater risk of admission and that they use this knowledge to develop anti-admission strategies specifically tailored to the needs of each individual group.

Primary care practitioners should seek access to a specialist diabetic team who they can refer to when deciding if a patient requires admission to hospital. Furthermore, they should access blood glucose and ketone testing to identify patients at risk of diabetic ketoacidosis that require hospital admission.

How Randox can Help

Randox offer a range of assays to diagnosis and monitor diabetes and to monitor associated complications.  Some of these tests are unique to Randox, including:

Fructosamine

The Randox fructosamine assay employs the enzymatic method which offers improved specificity and reliability compared to conventional NBT-based methods. The Randox enzymatic method does not suffer from non-specific interferences unlike other commercially available fructosamine assays.

Learn more about the Randox Fructosamine test

D-3-Hydroxybutyrate (Ranbut)

The Randox D-3-Hydroxybutyrate (Ranbut) assay detects the most abundant and sensitive ketone in the body, D-3-Hydroxybutyrate. The Randox Ranbut assay is used for the diagnosis of ketosis, more specifically diabetic ketoacidosis. Other commercially available tests, such as the nitroprusside method, are less sensitive as they only detect acetone and acetoacetate, not D-3-Hydroxybutyrate.

Learn more about the Randox D-3-Hydroxybutyrate test

Adiponectin

The Randox adiponectin assay is a biomarker in diabetes testing as adiponectin is a protein hormone responsible for regulating the metabolism of lipids and glucose and influences the body’s response to insulin. Adiponectin levels inversely correlates with abdominal visceral fat levels.

Want to know more?

Contact us or visit our Diabetes panel page to learn more.




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  • References

    [1] National Paediatric Diabetes Audit and Royal College of Paediatrics and Child Health, National Paediatric Diabetes Audit Report 2012-15: Part 2, 2017

    [2] NHS, “Avoiding Complications” – Type 1 Diabetes, Available at: https://www.nhs.uk/conditions/type-1-diabetes/avoiding-complications/ [Accessed on 24th October 2018].

    [3] “Potentially Preventable Pediatric Hospital Inpatient Stays for Asthma and Diabetes, 2003-2012”, www.hcup-us.ahrq.gov, 2015. [Online] Available: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb192-Pediatric-Preventable-Hospitalizations-Asthma-Diabetes.jsp [Accessed 08-Nov-18]


Automation vs. ELISA

Background

The technological developments and scientific innovations in the field of clinical chemistry from the early 1950’s to date have been vast, enhancing laboratory capabilities and providing the necessary support to clinicians and laboratories to improve patient diagnosis and treatment. (1) Laboratory automation today is a complex integration of robotics, computers, liquid handling and numerous other technologies with a fundamental purpose of saving time and improving performance through the elimination of human error.

Complementing this, in the early 1950’s ready-to-use assay reagent kits, with instructions for use introduced a very significant innovation to the field of automation eliminating the process of manually preparing reagent. (2)

Despite the many advancements in automation many clinical laboratories continue to use manual methods such as ELISA for some specialised tests. (3)

Inefficiencies with ELISA based methods

Manual ELISA based techniques are notoriously inefficient and are particularly draining on time and personnel due to the manual intervention required. The manual nature of the method also means there is greater potential for human error ultimately resulting in lack of sensitivity and potential for cross-reactivity. (4,5)

For many laboratories, the transition from traditional ELISA techniques to an automated method for the detection of the same analyte will significantly improve both costs and time.

Renowned for quality and reliability the RX series range of clinical chemistry analysers ensures confidence in patient testing.

DID YOU KNOW?

The RX Series of analysers allows for automation of specialised tests that previously would have only been possible via traditional ELISA methods e.g. Adiponectin, G-6PDH and Cystatin C.

 

Expanding Capabilities and Performance

With patient care holding a primary focus on clinical chemistry testing, the RX series range of semi-automated and automated analysers offer versatility to suit all laboratory requirements. Expanding your laboratory’s capabilities with our world leading extensive dedicated test menu offers cost savings through consolidation of both routine and specialised tests. By transitioning analytes historically only available as an ELISA based test, laboratories can expand their offering with ease to both patients and clinicians.

Our open system approach to clinical testing offers unique opportunities for consolidation, most of our unique and high-performance assays may be run on any clinical chemistry instrument without the need for specialised equipment.

Outperforming ELISA methodology, the RX series delivers a testing platform that requires limited or no manual preparation. With ELISA, the test is run on a 96 well plate using only a single assay with recommendations to duplicate or triplicate samples to evacuate the extent of errors, therefore increasing time and costs. The RX series of analysers each have different levels of throughput to adapt to the requirements of all laboratories.  Utilising robust hardware and intuitive software the RX series guarantees accurate and precise patient testing.

References:

  1. Olsen K. The first 110 years of laboratory automation: technologies, applications, and the creative scientist. J Lab Autom. 2012; 17:469-80.
  2. Rosenfeld L. A golden age of clinical chemistry: 1948-1960. Clin Chem. 2000; 46:1705.14.
  3. Kricja LJ, Savory J. International year of chemistry 2011. A guide to the history of clinical chemistry. Clin Chem. 2011; 57:1118-26.
  4. Wild D, Sheehan C, Binder S. Introduction to immunoassay product technology in clinical diagnostic testing. In: Wild D, editor. Immunoassay Handbook: Theory and Applications of Ligand Binding, ELISA and Related Techniques. 4th Oxford, UK: Elsevier; 2013.
  5. Hawker CDED. Laboratory automation: total and subtotal. Clin Lab Med. 2007; 27:749-70.

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