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    A short guideline on chronic kidney disease for medical laboratory practice
    (WALTER DE GRUYTER GMBH, 2016-01-01) Abusoglu, Sedat; Aydin, Ilknur; Bakar, Funda; Bekdemir, Tan; Gulbahar, Ozlem; Islekel, Huray; Ozarda, Yesim; Pektas, Macit; Pir, Kamil; Portakal, Oytun; Serdar, Muhittin; Turhan, Turan; Yucel, Dogan; Zengi, Oguzhan
    Chronic kidney disease (CKD) is asymptomatic in the early stage. Kidney function might be lost 90\% when the symptoms are overt. However, in case of early detection, progression of the disease can be prevented or delayed. If not detected it results in end stage renal disease. Therefore, the level of awareness about CKD should be increased. The role of medical laboratory is utmost important for the diagnosis and staging of CKD. In this paper, the main tasks of the laboratory specialists are described and the outlines are as follows. Creatinine assays should be traceable to internationally recognised reference materials and methods, specifically isotope dilution mass spectrometry. When reporting the creatinine result, eGFR should also be reported in adult (> 18 years) population. A warning expression should be included in the report form if eGFR result is <60 mL/min/1.73 m(2). eGFR values should be expressed quantitatively up to 90 mL/min/1.73 m(2) by CKD-EPI equation. Above 90 mL/min/1.73 m(2), eGFR values can be expressed quantitatively or >90 mL/min/1.73 m2. eGFR equations of the adult population should not be used for pediatric population. Different equations utilizing also patient height should be used. The enzymatic creatinine assay should be preferred. eGFR based on cystatin C can be used for confirmation in the pediatric population. Cystatin C measurements, at least when eGFR based on creatinine is not reliable and for confirmation should be encouraged. Proteinuria or albuminuria values should be measured in spot samples and reported in proportion to creatinine.
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    Ischemia-modified albumin and the IMA/albumin ratio in the dignosis and staging of hemorrhagic shock: A randomized controlled experimental study
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2020-01-01) Turedi, Suleyman; Sahin, Aynur; Akca, Metehan; Demir, Selim; Kose, Gokcen Derya Reis; Cekic, Arif Burak; Yildirim, Mehmet; Yulug, Ersin; Mentese, Ahmet; Turkmen, Suha; Acar, Sami
    BACKGROUND: To determine the value of ischemia-modified albumin (IMA) and IMA/albumin ratio (IMAR) in the diagnosis and staging of hemorrhagic shock (HS). METHODS: A pressure-targeted HS model was established in this study. The control and shock groups were monitored for 30 min and 60 min to simulate varying durations of exposure to HS. All subjects underwent invasive arterial monitoring during the experiment and were further divided into mild and severe shock groups based on decreases in mean arterial pressure (MAP). Biochemical and histologic comparisons were performed between the groups. RESULTS: Our results revealed higher IMA, IMAR, lactate, total oxidant status (TOS) and oxidative stress index (OSI) levels in both the 30- and 60-min shock groups compared to the control group. Concerning MAP-based shock staging, IMA, IMAR, lactate, TOS and OSI levels in the 30-min and 60-min mild and severe shock groups were higher than those of the controls. However, there was no significant difference between the mild and severe shock groups. A significant correlation was determined between all the biomarkers evaluated and HS-induced damage in various organs. This correlation was highest in lactate and IMAR levels. CONCLUSION: IMA and IMAR levels may be used in the early diagnosis of HS and also have the potential for use in determining the severity of HS. IMA and IMAR measurement may also be considered as an alternative or in addition to lactate measurement in the diagnosis of HS.