Neonatal health testing from Randox: what to expect after birth
It’s been almost a month since the Duke and Duchess of Cambridge welcomed Prince Louis into the Royal Family, and as reported it was a natural birth with no complications.
But caring for a newborn baby in the first few hours of its life isn’t quite as simple as it may have seemed in the picture-perfect media coverage of Kate and William introducing their third child to the world for the first time.
Behind the doors of the hospital maternity ward, doctors and nurses are busy carrying out a wealth of tests to ensure the health of the neonates in their care. Because the time immediately following a baby’s birth is crucial for their development in the coming months.
Newborn babies are particularly at risk for some diseases because their immune systems aren’t yet developed enough to fight bacteria, viruses and parasites. Just a few minutes after a baby’s arrival, they will be poked, pricked, measured, tested, examined, cleaned and swaddled – all in the name of making sure they are – and importantly, remain – healthy.
The first test to be conducted is usually an Apgar score – a simple assessment of how a baby is doing at birth, to help determine whether they are ready to meet the world without additional medical assistance. Based on heart rate, colour, reflex response, activity, muscle tone and breathing, the Apgar score ranges from zero to ten, with anything above seven or above being considered a healthy score. Babies with a score below seven will have their issues addressed – it could be something as simple as moving them to a warmer room until they are able to maintain their own body temperature, or clearing their nose and mouth for more efficient breathing.
The baby is then weighed and measured, and may be given antibiotic eye ointment to prevent infections, and vitamin K to prevent clotting problems.
They will also have their pulse, abdomen, genitals, fingers and toes examined, and their Ballard score taken. This takes into account head circumference, chest circumference and length, to confirm gestational age.
A paediatrician will then assess risk factors for infection and ensure that the baby is feeding well. They will also check for jaundice, which causes yellowish skin when bilirubin, a compound formed by the liver, isn’t being broken down properly.
Neonatal jaundice is extremely common, because during the first week of their life nearly every newborn develops a somewhat elevated bilirubin level, which could potentially lead to jaundice. And the good news is, that if diagnosed early, jaundice can easily be eradicated, by exposure to a specialist light that can help break down bilirubin.
At Randox, we offer a test for bilirubin to diagnose and monitor newborn jaundice, which, in rare cases if left untreated, can lead to brain damage. Early, accurate diagnosis is therefore imperative and so to ensure the precision of the bilirubin tests, Randox also offers Acusera Bilirubin Elevated Quality Control.
The baby will also have their heel pricked for a variety of metabolic conditions including sickle cell anaemia, which causes red blood cell destruction. The Randox test for haptoglobin, a protein found in blood plasma, can help to diagnose sickle cell anaemia.
Or if the baby is premature, they will remain in the hospital nursery. Depending on how premature the baby is there will be different types of tests and treatment given, but they will have their temperature, heart rate and respiratory rate closely monitored. These vital signs will be checked regularly for the first few hours of the baby’s life.
So as you can see, within just a few short hours newborn babies are kept incredibly busy. Procedures may vary from one hospital to the other, but one thing is for sure: neonatal tests are vital in determining and protecting the health of babies.
Randox is committed to saving and improving lives – at any age and any stage of life.
Our innovative diagnostic technologies are versatile and easily adapted for use in the paediatric setting – keeping your baby healthy now and into the future.
For more information on neonatal health tests available from Randox, please email email@example.com or phone 028 9442 2413
Most newborns enter the world healthy. But sometimes, infants develop conditions that require medical tests and treatment. Newborns are particularly at risk for some diseases, and in particular infections, because their immune systems aren’t developed enough to fight bacteria, viruses, and parasites.
At Randox we offer a number of accurate and reliable tests capable of detecting illnesses in newborn babies, enabling early medical intervention to allow for the best possible outcome for the baby.
Testing for Jaundice with Randox Bilirubin
In the routine care of newborns, a test for bilirubin is commonly conducted.
Bilirubin is formed by the breakdown of haemoglobin in the spleen, liver and bone marrow. It travels to the liver where it is secreted into the bile ducts as bile, and stored in the gallbladder where it is later released into the small intestines for digestion.
Increased levels of bilirubin within the body are associated with a condition called jaundice, which occurs in toxic or infectious diseases of the liver. The most common symptom of jaundice is a yellow pigmentation of the skin.
Elevated levels of bilirubin may also arise as a result of an obstruction in the bile duct or gall bladder, as a result of haemolysis (the destruction of red blood cells), or by the liver not actively treating the haemoglobin it is receiving.
Therefore the Randox Bilirubin test is essential in the screening, monitoring and diagnosis of hepatic (liver function) disorders and jaundice in newborn babies.
Neonatal jaundice, otherwise known as hyperbilirubinemia, is extremely common in babies, because nearly every newborn develops a somewhat elevated bilirubin level during the first week of life.
Side effects may include excess sleepiness or poor feeding, but in some more extreme cases babies may experience seizures, cerebral palsy, delayed intellectual development, or physical abnormalities.
Early and accurate detection is therefore extremely important – making bilirubin testing fundamental. To ensure the precision of the bilirubin tests conducted in paediatric testing, Randox also offers Acusera Bilirubin Elevated Quality Control.
Monitoring the destruction of red blood cells with Randox G-6-PDH
Glucose-6-Phosphate Dehydrogenase (G-6-PDH) is an enzyme located on the X-chromosome, and so is found in every bodily cell as soon as a baby is born.
G-6-PDH is involved in the normal processing of carbohydrates and plays a critical role in red blood cells, protecting them from damage and destruction. Depleted levels of G-6-PDH can therefore cause red blood cells to become particularly vulnerable to haemolysis. G-6-PDH deficiency, which causes rapid heart rate, shortness of breath, excess tiredness, and mild to severe jaundice in new-borns, affects more than 400 million people globally.
During a baby’s new-born screening, a test for the G-6-PDH enzyme will be conducted to check for this deficiency disorder. Early diagnosis is imperative, as untreated haemolysis can result in haemolytic anaemia.
Genetic Disease Screening with Randox Copper
Copper is an essential mineral in human nutrition, and is mainly found in the brain, liver, kidneys, heart and skeletal muscle.
It aids in some of the key bodily functions including the production of red blood cells, the maintenance of nerve cells and the immune system, and the formation of bone and connective tissue. A deficiency in this mineral can therefore result in bone abnormalities or fractures in premature babies.
Copper deficiency can also be caused by an inherited disorder called Menkes Disease. Affecting approximately 1 in 100,000 children worldwide, this condition is characterised by sparse, kinky hair; failure to gain weight and grow at the expected rate, and deterioration of the nervous system.
The first signs of Menkes Disease – curly, sparse, coarse, dull, and discoloured hair – usually first develop at 2-3 months of age and therefore monitoring copper levels in babies is a way to catch this rare condition at the earliest possible opportunity.
Testing for Lupus with Randox Complement C4 and Complement C3
Another condition which can affect newborn babies is neonatal lupus, which occurs when the mother’s antibodies affect the foetus. A rare condition, it is an autoimmune disease caused by the body’s immune system attacking its own tissues and organs.
The Complement C4 and Complement C3 proteins, which play an important role in eliminating certain infections, can be used as biomarkers in the diagnosis and monitoring of lupus. Complement C4 deficiency is commonly associated with lupus, as the protein is required to clear damaged cells, promote inflammation, and attack pathogens.
Although there is no cure for lupus at present, the condition is very treatable and usually responds well to a number of different types of medication – especially when treatment is started in the early stages of the disease.
Early diagnosis is therefore imperative, and the Randox Complement C4 and Complement C3 tests can help to diagnose babies with lupus at the earliest possible stage. Randox also offer Acusera Immunology controls.
Monitoring a baby’s anti-infection defences with Randox IgA
IgA (immunoglobulin A) is an antibody present in the cells of the immune system, and plays a crucial role in the immune function of mucous membranes including tears, saliva, and sweat. It is also present in colostrum, often referred to as ‘liquid gold’, which is the first secretion from the mammary glands after giving birth.
It’s the IgA in colostrum and milk that is important in neonatal protection against infection and it is therefore imperative to monitor the levels of this antibody to make sure your baby is receiving the anti-infection defences he or she requires.
Testing for allergic reactions with Randox IgE
IgE (immunoglobulin E) is an antibody released by the immune system as a defence mechanism when it believes the body is at risk. IgE determinations are therefore used as an aid in the diagnosis of allergic diseases.
In babies, an allergen-specific IgE test may be done to look for some kinds of allergies, including food, animal dander, pollen, mould, medicine, dust mites, or insect venom.
Increased concentrations of IgE will confirm that an allergic response has occurred, facilitating further investigation as to the specific allergy present.
Testing for bacterial infection with Randox CRP
C-reactive protein (CRP) is an acute phase protein found in blood plasma and produced by the liver. The concentration levels of CRP increase in response to cytokines which are produced by white blood cells during inflammation, infection and tissue injury.
Testing for this protein can therefore be used in the detection of bacterial infections in neonates – enabling antibiotic prescription and a speedy recovery. If infection is identified, CRP can also be used to monitor treatment response or identify neonatal septicaemia.
Randox is committed to saving and improving lives – at any age and any stage of life.
Our innovative diagnostic technologies are versatile and easily adapted for use in the paediatric setting – keeping your baby healthy now and into the future.
Many people talk about their metabolism as if it is a muscle or organ they can somehow control. In reality, your metabolism refers to a series of chemical processes in each cell that turn the calories you eat into fuel to keep you alive.
Metabolism is the biochemical process of combining nutrients with oxygen to release the energy our bodies need to function. Your resting metabolic rate (RMR) is the number of calories your body burns to maintain vital body functions such as heart rate, brain function and breathing. RMR accounts for up to 75 percent of the calories you burn each day. Knowledge of your individual RMR is a critical piece of information to appropriately establish daily calorie needs.
The body’s major organs — the brain, liver, kidneys, and heart — account for about half of the energy burned at rest, while fat, the digestive system, and especially the body’s muscles account for the rest.
Did you know?
Approximately 20-25% of the world’s adult population have metabolic syndrome?
A common misconception surrounding metabolic health is that it refers solely to your weight, and if you are overweight you are considered to be unhealthy. But in actual fact this may not be entirely true. Good metabolism means that your body is in good overall health, which doesn’t account for just your weight! Common metabolic disorders include genetic metabolic disorders, diabetes and metabolic syndrome. Understanding and testing to see how well your metabolism is functioning is key to ensuring long lasting health.
There are a number of genetic metabolic disorders caused by mutations of single genes. Examples of common disordersinclude Gaucher’s disease, hemochromatosis and cystic fibrosis. Gaucher’s disease is a genetic disorder that affects the body’s ability to break down fat that can accumulate in the liver/spleen and bone marrow. Hemochromatosis is a condition that is caused by the over-absorption and build-up of iron while cystic fibrosis is a metabolic disorder that appears as a result of a build-up of mucus in lungs/liver and intestines. Each of these metabolic disorders affect certain organs from functioning properly and therefore your overall healthiness.
Type 2 diabetes is one of the most common types of metabolic disorders in the world that is expected to affect 592 million people by 2035. It is characterised by high blood sugar, insulin resistance or a lack of insulin being produced by the pancreas. Insulin resistance occurs when the body isn’t able to use insulin the right way which increases blood glucose levels. Insulin is needed for cells to take in glucose (sugar) from the bloodstream and convert it into energy. Over time this lack of insulin can damage the organs in your body.
Metabolic syndrome (also known as syndrome X, Reaven’s syndrome, and CHAOS) is not a disease but a collection of risk factors that affect your health; these include high blood pressure, high blood sugar/cholesterol and abdominal fat. Left untreated, these risk factors, together, can lead to long term serious problems including an increased risk of heart disease, stroke and developing type 2 diabetes.
Can you improve your metabolic health?
Yes! The good news is that if you discover that your metabolic health is not up to scratch you can improve it through a combination of diet, exercise and lifestyle adjustments such as:
- 30 minutes of moderate to intense exercise 5-7 times a week
- Low-dose aspirin to reduce your risk of stroke or heart attack
- Quit smoking
- Medication for blood pressure/cholesterol/ blood sugar
- Limit alcohol intake
- Eat a healthy balanced diet
Randox has developed the RX series of clinical chemistry analysers for superior semi-automated and fully automated testing. The RX series extensive dedicated test menu goes beyond routine testing and has many unique and high-performance tests available. Our range of tests covers several parameters to assess your overall metabolic health.
Metabolic Health Profile
|Alkaline Phosphatase||C02 Total||Sodium|
|AST (GOT)||Glucose||Total Protein|
The RX series clinical chemistry analysers provide laboratories with a robust and smart solution ensuring you maintain a consistent workflow and can provide accurate results first time, every time. Offering excellent customer support services, our trained engineers are on hand to work with you in preserving the continuity of your operations while maximising the potential of your RX series instrument.Our world-famous test menu of high quality reagents ensures excellence in patient care, guaranteeing unrivalled precision and accuracy reducing costly test re-runs or misdiagnosis and offering complete confidence in results.
For more information visit: https://www.randox.com/clinical-chemistry-analysers/
Your heart is amazing. Not only is it your most critical organ but also one of the most hard-working. The average adult heart beats around 100,000 times a day, acting as a giant pump for all the blood in your body. Indeed, every day your heart pumps over nine litres of blood through a system of blood vessels over 60,000 miles long – it’s little wonder, then, the importance placed on looking after such a vital muscle.
The heart works 24/7, only taking a rest when you sleep with the natural drop of heart rate and blood pressure. Over time, and influenced by lifestyle choices, the heart grows weaker, needing to work harder to fulfil its function. Crucial lifestyle changes now could limit your risk of developing serious cardiac conditions, such as Cardiovascular Disease (CVD) in the future. Factors which can contribute to your CVD risk include genes inherited from parents or grandparents, smoking, an unhealthy diet, excessive alcohol consumption and low physical activity levels.
You can’t change your DNA, but you can find out what it means to you and your family. One of our advanced tests can identify people living with a common but often hidden disorder – Familial Hypercholesterolemia (FH). Fewer than 12% of people in the UK know they have this potentially fatal condition. It is characterised by dangerously high levels of cholesterol which can lead to early onset cardiovascular disease.
While lifestyle changes may help to limit your risk of CVD, and related heart condition, it is impossible to eradicate it completely for everyone. Accounting for 31% of deaths worldwide, CVD is the number one cause of death globally but early screening could lower this figure significantly. That’s why it’s vitally important to detect CVD early before a coronary event like a heart attack occurs.
Today in the UK, 530 people will go to the hospital with a suspected heart attack. Only a fifth of these people will actually be having a heart attack. According to a team from King’s College London, as reported by the BBC, a faster, more accurate diagnosis of whether chest pain is caused by a heart attack would save the health service millions of pounds each year by sending well patients home and freeing up beds. Yet current testing methods do not efficiently differentiate between high-risk patients and the estimated 80% of patients who are not having a heart attack.
Randox’s revolutionary test for Heart-Type Fatty Acid-Binding Protein (H-FABP), when combined with current testing, is able to rule out a heart attack for patients who present at A&E with chest pain which is caused by other conditions such as respiratory issues, meaning they may not need emergency admission.
When measured at the time a patient presents to A&E with chest pain, H-FABP enables doctors to triage patients suffering with a heart attack more efficiently than before, making sure those at high-risk are given medical intervention earlier.
Early screening in the form of a comprehensive health check is essential to detect cardiac irregularities before they become serious problems. Heart damage builds up over time, meaning that when detected early enough, lifestyle changes can help to reduce cardiac risk and potentially even prevent a cardiac event occurring.
Therefore, it is vitally important that individuals are tested for CVD to detect them in the earliest stages to reduce damage, prevent further damage, or even death. Furthermore, many people suffer from inherited cardiac risk factors, which stresses the need for accurate testing.
Randox offer the complete laboratory solution to cardiac risk assessment information to doctors and hospitals, and also directly to the public at Randox Health. Our range of both traditional and novel cardiac risk biomarkers, along with our technologically-advanced range of analysers, serves to allow us to offer the most advanced, most accurate health check available on the planet.
As well as your cardiovascular risk score, a Randox Health check will also assess your cholesterol levels, FH risk, triglycerides, creative kinase, myoglobin, troponin levels and many more heart health indicators. In total, a Randox Health check can assess up to 350 different markers of irregularity or disease in the whole body, from heart to hormone health and skin to stomach.
Many serious future health issues are preventable now with action. Find out more about our health check programmes here.
About Randox Health
Randox Health is a global leader in healthcare diagnostics; today more than 5% of the world’s population – in excess of 370 million people across 145 countries – receives medical diagnosis using Randox products each year.
After investing over £220 million in the invention and production of revolutionary blood-science technology, a single Randox Health check will deliver a complete picture of your health – as it is now and, crucially, how it is likely to develop in the future.
Randox Health has proven that signs of disease or irregularity can be caught at their earliest stage. This means that, with early action, some cases of illness can even be prevented altogether. Our health checks include, but are not limited to, cancer surveillance, fertility monitoring, heart health, nutrition, digestive and diabetes health.
In other words, from one health check, you’ll receive up to 350 results and afterwards avail of expert advice from the Randox scientists or a Randox Health GP. Not only that, but a complete 12-month programme and repeat testing come as standard so you can have full confidence that you are really taking care of yourself.
Find out more information about Randox Health checks here: https://www.randoxhealth.com/our-packages/
Randox has developed the RX series range of clinical chemistry analysers for high-quality semi-automated and fully automated testing. Choose between the RX misano, RX monaco, RX daytona+, RX imola, and the RX modena depending on the throughput of your laboratory. The RX series offers a suitable analyser for your laboratory’s needs. For more information on the Randox RX series, please click here or email firstname.lastname@example.org
Randox offers an extensive range of third party diagnostic reagents which are internationally recognised as being of the highest quality; producing accurate and precise results. We have the largest test menu of 118 assays, covering over 100 disease markers including specific proteins, lipids, therapeutic drug monitoring, drugs of abuse, antioxidants, coagulation, diabetes and veterinary testing. A wide range of formats and methods are available providing greater flexibility and choice for any laboratory size. In addition to flexible pack sizes and a comprehensive list of analyser applications, we can also provide dedicated reagent packs (Randox Easy Read and Easy Fit regents) for a wide range of chemistry analysers providing you with freedom of choice from an independent manufacturer.
Acusera – Internal Quality Control
The Acusera cardiac controls have been designed to cover a wide range of cardiac markers at clinical decision levels, eliminating the extra expense of an additional low level control. The controls are available in a both liquid ready-to-use and lyophilized formats making them ideal for all situations and manufactured from 100% human serum a matrix similar to that of the patient is guaranteed. For more information on the Randox Acusera internal quality control, please click here or email email@example.com
RIQAS – External Quality Control
The RIQAS Liquid Cardiac EQA programme is designed to monitor the performance of up to 9clinically significant cardiac markers including: CK-MB mass, D-dimer, Digoxin, homocysteine, hsCRP, myoglobin, NT proBNP, troponin I, and troponin T. RIQAS is ISO/IEC 17043 accredited and allows the registration of up to five instruments at no extra cost. All samples are 100% human serum and provided in a liquid ready-to-use format for enhanced convenience. Submit your results bi-weekly and view reports online via RIQAS.Net. For more information on RIQAS, the world’s largest international EQA scheme, please click here or email firstname.lastname@example.org
For further information, please contact the Randox PR team via email: email@example.com or phone 028 9442 2413
Here at Randox, we’re a diverse bunch, spread over 145 countries in the world. We have more than 1400 employees of 44 nationalities, including 300 research scientists and engineers. Needless to say, the Randox family is a multicultural one!
We have four key manufacturing and R&D sites – in County Antrim, Northern Ireland; Dungloe, County Donegal, Ireland; Bangalore, India; and the Greater Washington DC area, in the U.S. This month, our We Are Randox article focuses on the team in Bangalore.
Randox India, located alongside other high-tech industries based in Bangalore, consists of 37 office staff and 77 field staff, including customer support engineers and sales managers. A base for administration, sales and manufacturing in India, the Bangalore site, set in the capital of the Indian state of Karnataka, services the 3.3 million square kilometre country.
Photographed are members of the Randox team in Bangalore from the following departments;
- Accounts and Finance
- Customer Support Engineers
- Logistics and Trading
- Quality Control
- Research & Development
- Human Resources
Brian Walsh, Manufacturing Manager at Randox India, said:
“The photograph below was taken during this year’s Diwali, which is the Hindu festival of lights celebrated every year in autumn in the northern hemisphere. Danny Maguire, who is based in Ardmore at Randox HQ, was over on business at the time and joined us in celebrating this cultural tradition.
“It is one of the most popular festivals of Hinduism, and spiritually signifies the victory of light over darkness, good over evil, knowledge over ignorance, and hope over despair.
“We all really enjoyed having Danny with us and sharing some of our customs and values with him, many of which our team members based in other sites across Randox would not know about.
“We hope to welcome many more of our colleagues from across the globe to Randox India in the near future!”
Want to know what it’s like to work in Bangalore? Read all about when we met up with Pankaj Chitkara, who is our National Sales Manager for the RX Series in India.
For further information on the Randox Bangalore team, please contact the Randox PR team via email: firstname.lastname@example.org or phone 028 9442 2413
Randox Clinical laboratory Services (RCLS) is the latest offering from Randox, Built over 35 years of experience producing high quality IVD products, Randox Clinical Laboratory Services (RCLS), is dedicated to providing a clinical laboratory service designed to meet the time sensitive, bespoke requirements of research and clinical projects globally.
RCLS currently has four state of the art, fully functional ISO12025 accredited laboratories across the UK. They are situated in Liverpool, London and two in Northern Ireland, Hollywood and Randox Science Park in Antrim. RCLS looks to expand their team of experienced scientists, working towards further accreditations and furthermore setting up two additional labs in Dubai and Los Angeles. The addition of these purpose built labs will give RCLS the ability to increase output to both the health and research market.
Ann-Marie Jennings, Laboratory Manager for Randox Clinical Laboratory Services, discusses the Randox Biochip Array, RCLS’ abilities and confidence in testing;
“On our patented Randox Biochip Array Technology we can customize bespoke testing platforms based on the requirements of each drug development project, which can be a challenging process. From initial product development to clinical trial stages there can be a number of barriers and time constraints before drugs are successfully released to the public. We’re confident that our newly enhanced capabilities will benefit patients suffering from conditions in most need of research by offering pharmaceutical companies at the forefront of pioneering research, with the latest technological developments.”
Thanks to these state of art laboratories, RCLS will now be able to provide an increasingly wide range of testing services to Biotechnology, research and pharmaceutical companies delivering the testing services required to support their research and drug development projects.
With the ability to conduct an unrivalled range of health testing – haematology, biochemistry and immunoassay – all under one roof, the laboratory offers unparalleled support services to the dynamic and growing healthcare industry. With a greater understanding of human complexity, pharmaceutical companies are now focusing on developing safer drugs tailored to specific patient groups or sub-groups and the expansion plans in motion at RCLS will help these organisations bring new drugs to market faster.
If you would like more information on Randox Clinical Laboratory Services, please contact us by emailing us at email@example.com
In celebration of British Science Week 2017, we will be giving you an introduction to diagnostics, and exploring how Randox Scientists are helping to change healthcare.
You may or may not already know that Randox are one of the leading diagnostics companies globally. But what exactly does clinical diagnostics involve? It is one of the fundamental steps of finding out what is wrong with a person when they are ill. Read on to find out a bit more about diagnostics, and how the Randox Reagents R&D Scientists are helping to change healthcare globally!
What is a diagnostic test?
A diagnostic test is any kind of analysis performed on a patient sample (a sample is typically blood, urine or cerebrospinal fluid (CSF)), to aid in the diagnosis or detection of disease. The information found from a test can be used to:
- Diagnose disease
- Assess the extent of damage
- Monitor the effectiveness of treatment
- Confirm a person to be free from disease
Examples of substances that may be tested for the blood include proteins, nutrients, waste products, antibodies, hormones, salts, trace elements or vitamins. These are sometimes referred to as ‘analytes’, ‘markers’ or ‘biomarkers’.
This is where reagents come in…
A reagent is a substance which is mixed with the patient sample to create a chemical reaction to detect the biomarker. These reactions are analysed by machines known as analysers.
Using data gathered from both clinical symptoms and laboratory tests, the doctor will follow a sometimes painstaking process of analysis and elimination to perform a successful diagnosis!
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…
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.
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.
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.
We are encouraging you to #LoveYourHeart this Valentine’s Day! Read on to find out why your heart health should matter to you this #HeartMonth!
Fact: Did you know people with diabetes are 2 to 4 times more likely to develop cardiovascular disease than people without diabetes?¹
Good diabetes control is imperative! If you have diabetes take control and monitor your treatment to ensure you are safe from complications such as cardiovascular disease…
Many complications associated with diabetes include kidney disease, eye disease, cardiovascular disease and diabetic ketoacidosis (a life threatening condition that can develop in insulin dependent diabetics).
If you have diabetes, being physically active and controlling your weight and blood pressure will help manage your blood sugar level; and therefore help manage the risk of cardiac diseases.
However a few simple routine tests may also be carried out to ensure normal kidney function. Normal kidney function in a diabetic patient means that diabetes is being controlled well, however if kidney function begins to deteriorate then you will know that measures need to be taken to control diabetes better.
Speciality tests to assess kidney function which can be requested include:
- Cystatin C – a sensitive marker of kidney function used for detection of early renal dysfunction in diabetic patients. It is important to note that Creatinine is the routine test for renal dysfunction, however it has a blind range which means it is unable to detect elevated Creatinine levels found in stage 2 and halfway through stage 3 renal dysfunction; as a result 50% of kidney function can be lost before elevated Creatinine levels can be seen. The Cystatin C test is a much more sensitive marker and can detect early stages of renal dysfunction, allowing treatment to begin before it is too late.
- Beta-2 Microglobulin – this test is used when kidney damage has occurred to distinguish between the two most commonly affected sites, glomeruli and renal tubules.
Fact: Cardiovascular Diseases are the number one cause of death globally, with more people dying annually from CVDs than any other cause.² In the UK alone, 41,000 people under the age of 75 die from CVD each year.³
If you are worried about your cardiovascular health, or whether you are at risk of a heart attack or stroke, ask your doctor for a cardiovascular risk assessment. Routinely they will run lipid tests such as Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides to assess your overall cholesterol and triglyceride levels, and allow corrective action to be taken.
Look out for hidden risk factors!
Specific tests you may also want to discuss with your doctor include:
- sLDL Cholesterol and Lipoprotein(a) to assess for genetically inherited risks of cardiovascular disease – even if your cholesterol levels are safe you may still be at risk of cardiovascular disease as a result of familial traits
- Adiponectin to assess the level of abdominal visceral fat, of which high levels can increase your cardiovascular risk. Please note that abdominal visceral fat levels or body fat cannot be determined by BMI score, which assesses whether weight is within a healthy range. As such, the Adiponectin test provides a clearer indication of health and is a good predictor of cardiovascular risk
- TxBCardio to assess response to Aspirin therapy for the prevention of cardiovascular disease. Up to 30% of patients receiving Aspirin therapy suffer unknowingly from Aspirin resistance. This test enables treatment to be modified and corrected
Asking your doctor for these tests creates an opportunity for corrective action to be taken and can have significant benefits for your health.
Fact: Approximately one woman dies from heart disease every minute, of which 64% had no previous symptoms.4
Sixty-four percent of women who die suddenly of coronary heart disease had no previous symptoms. Because these symptoms vary greatly between men and women, they’re often misunderstood. Media has conditioned us to believe that the telltale sign of a heart attack is extreme chest pain. But in reality, women are somewhat more likely to experience shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen and extreme fatigue.
Being aware of these signs can aid early detection, and greatly increase chances of surviving a heart attack!
So don’t forget to #LoveYourHeart this Valentine’s Day! Randox can provide a vast range of specialised blood tests to allow the most accurate diagnosis of diabetes, cardiac risk and associated complications. From all of us here at Randox we wish you an enjoyable Valentine’s Day!
Following recommendations from recognized institutions such as ISO and CLIA, more laboratories are using third party controls than ever before. However, great care should be taken when choosing which third party control to use. A number of factors should be considered, and primarily among these is whether the control challenges the complete Clinical Range and the Medical Decision Levels. ISO 15189:2012 states that ‘The laboratory should choose concentrations of control materials wherever possible, especially at or near clinical decision values, which ensure the validity of decisions made’.
Measuring the Complete Clinical Range
It is important to assess the full clinical range of an assay i.e. the range between the lowest and highest results which can be reliably reported. In order to make sure a laboratory instrument is working across the full clinical range, a QC which covers low, normal and elevated concentrations must be used.
Question: “If the full clinical range isn’t covered by QC, how will we know whether patient results which fall outside the range of quality controls are accurately reported?”
What are Medical Decision Levels?
Medical Decision Levels (MDL) are the analyte values at which medical professionals can determine whether a patient may be suffering from a certain condition. The MDL is determined by a consensus of medical professionals and clinical research. Patients’ test results are compared to the MDL and appropriate diagnoses or medical interventions can be made.
For example, the MDL of Glucose can indicate a certain diabetic status:
|Analyte||Medical Decision Level||Diagnostic Status|
|Glucose (fasting)||<100 mg/dL||Non-Diabetic|
Many QC manufacturers ‘cut corners’ in an attempt to keep costs down, which often results in the sale of controls which do not cover the complete clinical range or vital medical decision levels. Below is an example of the Glucose concentrations present in a competitor control:
Competitor Chemistry Control Level 1 – 68 mg/dL
Competitor Chemistry Control Level 2 – 134 mg/dL
Competitor Chemistry Control Level 3 – 386 mg/dL
In the examples above, the competitor’s level 1 control covers the non-diabetic MDL, but the level 2 control is not within the ‘Pre-Diabetic’ decision range. The level 3 control is also much higher than can be expected for an elevated diabetic patient result (200 mg/dL or more).
Due to the superior manufacturing process used by Randox, QC target values are consistently within the MDL of tests. For example, the Glucose concentrations present in our Liquid Assayed Chemistry Premium Plus control are:
Level 1 – 57 mg/dL
Level 2 – 114 mg/dL
Level 3 – 236 mg/dL
The MDL for Glucose is covered by the Randox control, meaning laboratory professionals can be confident that patient results will be accurately interpreted.
Immunoassay Medical Decision Levels
Controls which cover the MDL can reduce the number of Quality Controls required by laboratories. For example, Randox Acusera Lyophilised Immunoassay Controls contain particularly low levels of TSH, Ferritin and Vitamin B12 in the Level 1 control, eliminating the need for an additional control at extra expense:
|Analyte||Medical Decision Level||Randox Level 1 IA Control||Competitor Level 1 IA Control|
|TSH||0.1 or 0.27 uU/mL||0.15uU/mL||0.37 uU/mL|
|Vitamin B12||190 pmol/L||174 pmol/L||327 pmol/L|
|Ferritin||12 ng/mL||11.1 ng/mL||49.6 ng/mL|
In this example the competitor offers an anaemia control with lower levels of TSH, Vitamin B12 and Ferritin at an additional cost. With Randox Acusera QC, only one control is required for anemia monitoring and detection.