Is Biomarker Multiplexing the future of kidney disease screening?

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Is Biomarker Multiplexing the future of kidney disease screening?

Chronic Kidney Disease (CKD) is both a cause and a consequence of cardiovascular diseases, and is an increasing burden on global health. As diabetes, obesity and hypertension incidences continue to rise and the world’s population steadily ages, CKD’s prevalence is already estimated to be between 11% and 13% globally for all five KDOQI stages, with a majority in Stage 3 (about 90% of all stages).

With early stages of CKD being asymptomatic and current diagnostic tools (proteinuria determined by albumin to creatinine ratio and decreased renal function estimated from GFR using the CKD-EPI equation) are insufficiently sensitive to detect most cases up to stage 3, it is likely that the true prevalence of CKD is still underestimated. Therefore the need to improve both early diagnostics and overall CKD outcome is all the more critical.

Accordingly, biomarker research has been intense in the field of renal disease for at least 10 years with a number of promising candidates emerging, some now well-known by specialists: Cystatin C, NGAL or KIM-1 for example.

However, further novel biomarkers, assessed in combination using a properly developed multiplex assays can allow superior insight into CKD than what their individual performance could achieve.  This also largely stems from selecting the markers that are indicative of complementary mechanisms that contribute to the development of CKD.

When assayed together from a single serum sample and after combinatorial analysis has been applied, these biomarkers can open new avenues in the management of CKD, such as proper diagnosis of the condition from Stage 1, clear differentiation between stages and monitoring of the progression pace of the disease. Early screening of patients at risk of CKD is now within reach and it is expected that its systematic use will have a profound impact on health system economics.

Another area of interest in renal research is Acute Kidney Injury (AKI) which may arise as a result of cardiac surgery and can subsequently lead to CKD. AKI detection is also of significant interest in the field of drug development, where early stage toxicity is still a large cause of new drug marketing withdrawal. Hence selecting and qualifying kidney tissue damage biomarkers, and assembling them into a multiplex panel is a key priority to those involved in early stage clinical trials.

An AKI panel has been worked out using the same principles as those used in the development of the CKD panel: high individual diagnostic value and multiple, independent cellular targets. This panel is now ready for final clinical qualification and will be one of the first of several organ-targeted safety panels aiming to become standard for drug induced toxicity screening.

It is key to the adoption of multiplex testing that proper validation guidelines be published and that careful, matrix-based validation data is made available to potential users. It is essential that multiplexed testing comes to the front line of testing in the field, so it can deliver to its full potential and start translating into public health improvement and cost savings. Technology is ready, let’s make a start!

Dr Claire Huguet

Randox Biosciences – Head of Biomarkers

 

For further information about kidney disease screening from Randox Biosciences, please contact randoxpr@randox.com

 

 

 


Looking after your kidney health during your pregnancy

With this year’s World Kidney Day theme focusing on women’s health and in particular, their kidney health, the campaign is drawing attention to the need for a higher awareness, timely diagnosis and proper follow-up of kidney issues amongst women.

One key area being highlighted by the campaign is the close links between pregnancy and kidney health problems.  The two are intrinsically connected – with CKD considered a high-risk factor for problematic pregnancies and reduced fertility, and in turn, pregnancy-related complications, including preeclampsia, can increase the risk of kidney disease.

Although not commonly known, women who have Chronic Kidney Disease are at increased risk of hypertensive disorders and premature births – which can be devastating for all involved.

Women with Chronic Kidney Disease who become pregnant also usually have mild kidney dysfunction, the severity of which will depend on the stage the CKD is at.

It is clear therefore that there is a need for increased awareness of Chronic Kidney Disease in pregnancy, to timely identify its existence before conception, and to monitor its progress before, during and after birth.

With a comprehensive panel of kidney health tests, Randox are working to ensure timely diagnosis of kidney function problems, to ensure that necessary treatment is administered at the earliest possible stage, when it is most likely to be successful.

Pregnant women, or women hoping to get pregnant in the future, can therefore determine their kidney health and be empowered to embark upon the necessary lifestyle changes or treatment required to ensure a safe and healthy pregnancy.

For example, the Randox test for albumin, low concentrations of which are the earliest marker of kidney damage, can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

In addition to albumin, there are a number of other highly specific and sensitive tests for kidney health, which are available as part of a Randox Health Check at our Randox Health Clinics. These include;

  • Estimated Glomerular Filtration Rate, which is an equation that considers age, gender, blood and protein levels to determine how well the kidneys are functioning.
  • Creatinine, which is a waste product produced by muscle tissue, and removed by the kidneys. When kidney function is diminished, creatinine levels increase.
  • Other proteins within the body which should be filtered by the kidneys, and are therefore measured to determine kidney function, include;

–              Cystatin C

–              Beta-2-Microglobulin

–              Microalbumin, which is not usually found in urine, but can appear when normal kidney function is impaired.

  • Minerals processed by the kidneys and analysed by Randox Health include;

–              Magnesium

–              Calcium

–              Phosphate

–              Potassium

–              Sodium

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With access to these high-performance kidney health tests, expectant mothers with kidney problems can be diagnosed early, before the condition develops into something more serious – keeping both you, and your baby healthy.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

 

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today. Speak to our team by phoning 0800 2545 130.

 

 

 


Randox Testing Services: Customer Testimonials from Ireland

At Randox Testing Services (RTS), we pride ourselves on helping our customers improve the health and safety of their working environment. Using our accurate and reliable testing methods and a range of additional services including training and policy reviews, we create tailored packages to meet the needs of our customers. We work with customers all over the world, but this month are highlighting the work we are doing across Ireland.

This month RTS will be attending the Northern Ireland Occupational Health, Hygiene and Wellbeing Conference at Titanic Belfast. This conference brings together companies from a range of industries all across Ireland to discuss the importance of employee health and wellbeing. As a company that began in Northern Ireland, RTS have always had strong connections with local businesses and are continually expanding our reach across Ireland.

Some of the companies with which we currently work, like GRAHAM construction, have recently provided feedback on our services. GRAHAM is based in Hillsborough, Co. Down and is a national construction, asset management and project investment business. They deliver services to a diverse range of clients from a network of regional offices, throughout the UK and Ireland.

GRAHAM Construction are proud to be partnered with Randox as their main Drug & Alcohol Service Provider. Over the years they have given a consistent, prompt, efficient, and professional service that delivered what was promised, when promised, to the proper agreed standards, which assists us in managing our relevant responsibilities with ease and confidence. I would have no hesitation in recommending them to others.”

This is great feedback to receive from such a reputable company who have a range of different testing needs. The construction industry is becoming more and more proactive when it comes to drug and alcohol testing. At RTS our experience working with GRAHAM and other major construction firms across the UK and Ireland means we are extremely well equipped to deal with the changing needs of this industry.

Another industry which requires a flexible and reliable drug and alcohol testing services provider is the aviation industry, especially when it comes to recruitment. We have been working with CAE Parc Aviation Services, the global leader in the provision of aviation personnel and support services to conduct pre-employment testing.

“We use Randox for Pre-Employment and Random Drug & Alcohol testing for select clients. We would happily recommend their services.”

Again, through working with various industries, the experience our staff possess is second to none. By qualifying the exact needs of our customers we create customised, cost-effective packages to ensure all testing needs are met.

As well as offering drug and alcohol testing services, our complete solution also includes a host of training, educational and consultancy services to equip our customers in tackling drug and alcohol misuse. Including comprehensive chain of custody training programs, which enables employers to conduct on-site collections to the same standard as a Randox Testing Services collection specialist.

The Henderson Group in Newtownabbey are another large company that has availed of the services offered by Randox Testing Services. The Henderson Group are the owners of the SPAR, EUROSPAR, ViVO, ViVOXTRA and ViVO Essentials franchises in Northern Ireland and have been distributing food and grocery-related products to the convenience retail sector for over 100 years.

“We switched provider for our Drug and Alcohol policy almost two years ago, moving to Randox.  The switchover was relatively seamless and the impact on our business has been positive.  Our tests are now all completed within target and we have realised a saving to boot.  We are glad we made the switch.”

 

 

Randox Testing Services is committed to tailoring our service to the needs of customers all over the world, and across the island of Ireland.

If your company would like to speak to us, please contact testingservices@randox.com

Alternatively you can contact David O’Regan, the Business Development Executive for Ireland directly: David.O’Regan@randox.com.

 

 


Take a proactive approach to your kidney health this World Kidney Day

On 8th March 2018, it’s World Kidney Day, a global campaign aimed at raising awareness of the importance of good kidney health. With a similar agenda to that of Randox, whose vision it is to ensure patients across the globe have access to the latest advancements in health technology, World Kidney Day works to reduce the frequency and impact of kidney disease and its associated health problems.

This year, the World Kidney Day theme is Kidneys and Women’s Health, to highlight that approximately 195 million women worldwide are affected by Chronic Kidney Disease. In 2018 World Kidney Day and International Women’s Day are recognised on the same date, offering the perfect opportunity to reflect on the importance of women’s health and specifically their kidney health.

CKD is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.

According to some studies, CKD is more likely to develop in women compared with men, with an average 14% prevalence in women compared to 12% in men.

However, the number of women successfully put on dialysis for their Chronic Kidney Disease is lower than the number of men – potentially due to slower progression of the disease, inequitable access to transplantation, and a general lower disease awareness.

It is therefore fitting that World Kidney Day has chosen Women’s Health as its theme for this year – due to the clear need for a higher awareness, timely diagnosis and proper follow up of kidney issues amongst women.

With a comprehensive panel of kidney health tests, Randox are working to ensure timely diagnosis of kidney function problems, to ensure that necessary treatment is administered at the earliest possible stage, when it is most likely to be successful.

For example, the Randox test for albumin, low concentrations of which are the earliest marker of kidney damage, can identify individuals with diabetic nephropathy (damage to the kidneys caused by diabetes) around 10 years earlier than standard protein tests. The Randox albumin test can therefore enable preventative measures to be taken to reduce your risk of developing kidney disease.

In addition to albumin, there are a number of other highly specific and sensitive tests for kidney health, which are available as part of a Randox Health Check at our Randox Health Clinics. These include;

  • Estimated Glomerular Filtration Rate, which is an equation that considers age, gender, blood and protein levels to determine how well the kidneys are functioning.
  • Creatinine, which is a waste product produced by muscle tissue, and removed by the kidneys. When kidney function is diminished, creatinine levels increase.
  • Other proteins within the body which should be filtered by the kidneys, and are therefore measured to determine kidney function, include;
  • Cystatin C
  • Beta-2-Microglobulin
  • Microalbumin, which is not usually found in urine, but can appear when normal kidney function is impaired.
  • Minerals processed by the kidneys and analysed by Randox Health include;
  • Magnesium
  • Calcium
  • Phosphate
  • Potassium
  • Sodium

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With access to these high-performance kidney health tests, patients with kidney problems can be diagnosed early, before the condition develops into something more serious.

Although end stage kidney failure affects only 0.05% of the general population, it commands between one and two billion pounds a year of the entire annual NHS budget. We know that loss of kidney function is devastating and hope our innovations can identify those at risk of kidney problems before they occur.

One such test for Chronic Kidney Disease risk measures levels of the protective hormone adiponectin, and is available exclusively at Randox.

Adiponectin can accurately assess levels of hidden and dangerous visceral fat within the body, which is the main cause of almost all the disorders associated with metabolic syndrome, including Chronic Kidney Disease. Assessing adiponectin can determine risk of CKD, as well as a range of other illnesses including prediabetes, cardiovascular disease and various cancers.

By using adiponectin to assess risk of kidney problems, we can empower individuals with the tools they need to prevent kidney problems in their future.

With early diagnosis we can improve patient treatment outcomes and reduce the number of people across the world suffering with kidney health problems.

If you are a clinician or lab interested in running renal function assays, download our Reagents Brochure or email reagents@randox.com

If you want to find out the status of your own Kidney Health, book a health check with Randox Health today. Speak to our team by phoning 0800 2545 130.

 


Randox Reagents celebrate World Kidney Day 2017

On 9 March 2017, Randox Reagents are celebrating World Kidney Day!  World Kidney Day is a global campaign aimed at raising awareness of the importance of our kidneys to our overall health. It aims to reduce the frequency and impact of kidney disease and its associated health problems worldwide.

This year, the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviours an affordable option.

With this in mind, throughout the week we have been sharing on social media some interesting facts on diagnostic tests which can help aid an early risk assessment of kidney disease in obese patients, allowing preventative action to be taken before any serious damage occurs.  The tests of focus this week included cystatin C, adiponectin and microalbumin

Cystatin C

The creatinine test is routinely run for patients who are suspected for deteriorating kidney function, however this test has limitations.  Cystatin C is an alternative test, and is particularly useful in patients where creatinine measurements are not suitable e.g. individuals who are obese, malnourished, have liver cirrhosis or reduced muscle mass. Importantly, unlike creatinine, cystatin C does not have a ‘blind area’ – up to 50% of kidney function can be lost before significant creatinine elevation occurs. Cystatin C is extremely sensitive to very small changes in kidney function and is therefore capable of detecting early stage kidney dysfunction.  The cystatin C test therefore allows preventative measures to be taken much earlier and before significant kidney function decline.

Adiponectin

There is substantial evidence that excess visceral fat is the main driving force for almost all of the disorders associated with the metabolic syndrome, including CKD.1,2 The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level.3,4  Assessing adiponectin, and therefore visceral fat levels, can help assess risk of CKD, as well as a range of other illnesses such as pre-diabetes, CVD and various cancers.

 

Microalbumin

The microalbumin test detects very low levels of a blood protein called albumin, in urine. The detection of albumin in urine can be an indicator of kidney injury and can result in irreversible damage if left untreated. Low albumin concentrations in the urine are the earliest marker of kidney damage and therefore enable preventative measures to be taken.  Microalbumin testing can identify individuals with diabetic nephropathy approximately 5-10 years earlier than proteinuria tests helping reduce the frequency of end stage renal disease.

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With continuous investment in R&D, Randox are helping with the risk assessment and earliest detection of renal function problems. By assessing one’s risk of kidney problems (with the adiponectin test), it can give patients (obese and other) the tools to prevent kidney problems further on down the line.  With early diagnosis (through the cystatin C and microalbumin tests) it will be possible to keep kidney problems from getting worse, therefore lowering the number of those diagnosed with CKD worldwide.

For health professionals

If you are a clinician or lab interested in running renal function assays, Randox offers a large range of high quality routine and niche assays including:  Cystatin C, Creatinine Enzymatic and Jaffe, Microalbumin, Urinary Protein, Urea, Sodium, Potassium, Albumin, Ammonia, β2- Microglobulin, Calcium, Chloride, Glucose, HbA1c, IgG, LDH, Magnesium, Phosphorus (Inorganic), and Uric Acid. These can be run on most automated biochemistry analysers.

For more information, download our Diabetes Brochure or email reagents@randox.com.

References

  1. Hall JE, Henegar JR, Dwyer TM, et al. Is obesity a major cause of chronic renal disease?Adv Ren Replace Ther. 2004;11(1):41–54. [PubMed]
  2. Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update.Physiol Rev. 2013;93(1):359–404. [PubMed]
  3. Matsuzawa, Y. The role of fat topology in the risk of disease.  Int J Obes.  2008;32:s83-s92.
  4. Frederiksen, L., Nielsen, T. L., Wraae, K., Hagen, C., Frystyk, J., Flyvbjerg, A., Brixen, K. and Andersen, M. Subcutaneous Rather than Visceral Adipose Tissue Is Associated with Adiponectin Levels and Insulin Resistance in Young Men.  JCEM, (2009) 94 (10): 4010-4015.

 

Further reading:


What is the relationship between kidney function and abdominal fat?

It is widely understood that hypertension and diabetes are two of the most common causes of chronic kidney disease (CKD), a long-term condition where the kidneys do not work effectively. But what about abdominal fat?

Abdominal fat contributes to risk of diabetes and hypertension, and with these being the most common causes of CKD, it’s natural to associate abdominal fat with CKD, isn’t it? A new study has recently been published which examines this.

The study(1) aimed to examine the relationship between kidney function and abdominal fat; the researchers wanted to discover if abdominal obesity is associated with early markers of CKD in a young healthy population, and whether these associations differ by race and/or ethnicity.

As symptoms of CKD are not usually present until the condition reaches an advanced stage, blood and urine tests are relied on to detect the condition at earlier stages, and enable treatment to begin as early as possible. The identification of more indicators to enable this condition to be detected as early as possible is of interest, particularly due to 10% of the world’s population being affected by CKD(2).

The study involved the analysis of data gained from The National Health and Nutrition Examination Survey (NHANES) in the US between 1999 and 2010. This included health, lifestyle and nutritional information from 6918 young adults aged 20-40 years; factors included height, weight, waist circumference, blood pressure and blood/urine samples for analysis of components including albumin, CRP, glucose, insulin, creatinine etc.

The researchers of the study defined abdominal obesity by gender criteria of waist circumference, and markers of CKD included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Risk of CKD was analysed within strata of race and in subgroups of those with normal blood pressures, normal blood sugar levels and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria.

The study concluded that abdominal obesity in young adults, especially in Mexican-Americans, is independently associated with early markers of kidney dysfunction even in those with normal blood pressures, glucose levels and insulin sensitivity.

References:

  1. Sarathy H et al. (2016) Abdominal Obesity, Race and Chronic Kidney Disease in Young Adults: Results from NHANES 1999-2010. PLoS ONE 11(5): e0153588. doi:10.1371/journal.pone.0153588
  2. World Kidney Day (2016) Chronic Kidney Disease. Online at: http://www.worldkidneyday.org/faqs/chronic-kidney-disease/

Please note:

With the prevalence of obesity, greater awareness of CKD is needed to protect the youth from premature kidney dysfunction. Those at high risk of CKD should be screened every year. This includes patients with high blood pressure (hypertension), diabetes, or a family history of CKD. If symptoms are experienced visit your GP – symptoms of advanced CKD include tiredness; swollen ankles, feet or hands (due to water retention); shortness of breath; nausea; and blood in the urine.

For health professionals: The adiponectin test from Randox can accurately assess levels of abdominal visceral fat, independent of age, race or fitness level.  Assessing adiponectin, and therefore visceral fat levels, can help assess risk of CKD, as well as a range of other illnesses such as pre-diabetes, CVD and various cancers.  Contact us now for further information.


Support World Kidney Day with Randox Renal Function Tests

World Kidney Day is a global campaign aimed at raising awareness of the importance of our kidneys to our overall health. It aims to reduce the frequency and impact of kidney disease and its associated health problems worldwide.

The main objectives of World Kidney Day are to educate all medical professionals about their key role in detecting and reducing the risk of Chronic Kidney Disease (CKD), particularly in high risk populations, and to stress the important role of local and national health authorities in controlling the CKD epidemic. On World Kidney Day all governments are encouraged to take action and invest in further kidney screening.

World Kidney Day highlights the need for more accurate kidney function testing for better diagnosis and monitoring of kidney function to assist in the development of appropriate treatment plans. As such, Randox have invested in the development of more sensitive and specific renal function tests such as cystatin C, which may be requested if kidney function is found to be borderline using the more routinely run creatinine test. Doctors may request cystatin C to check for early kidney disease and/or to monitor known impairment over time.

Cystatin C is a particularly useful marker of renal function in patients where creatinine measurements are not suitable e.g. individuals who are obese, malnourished, have liver cirrhosis or reduced muscle mass. Importantly, unlike creatinine, cystatin C does not have a ‘blind area’ – up to 50% of renal function can be lost before significant creatinine elevation occurs. Cystatin C is extremely sensitive to very small changes in GFR and is therefore capable of detecting early stage kidney dysfunction.

Both World Kidney Day and Randox are working towards improving healthcare worldwide. With a comprehensive panel of high performance reagents, Randox are helping with the detection and characterisation of renal function problems. With early diagnosis it will be possible to keep kidney problems from getting worse, therefore lowering the number of those diagnosed with CKD worldwide.

If you are a clinician or lab interested in running renal function assays, Randox offers a large range of high quality routine and niche assays including:  Cystatin C, Creatinine Enzymatic and Jaffe, Microalbumin, Urinary Protein, Urea, Sodium, Potassium, Albumin, Ammonia, β2- Microglobulin, Calcium, Chloride, Glucose, HbA1c, IgG, LDH, Magnesium, Phosphorus (Inorganic), and Uric Acid. These can be run on most automated biochemistry analysers.

For more information, download our Reagents Brochure or email reagents@randox.com.


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