Acute Renal Failure Clinical Trial
Official title:
Can Modern Urinary Markers be Used as Markers for Acute Kidney Failure Due to Stone Obstruction
Renal colic is usually caused from an obstructing stone along the ureter. Some of the
patients present with a high level of creatinin in the blood, even though there is a normal
functioning contralateral kidney. Furthermore creatinin is not an ideal marker for renal
function during acute changes.
Several works have shown that modern urinary markers such as NGAL (neutrophil
gelatinase-associated lipocalin), KIM-1 (Kidney Injury Molecule-1) and others rise earlier
and are much more sensitive for kidney insult. There is a lack of research on their role in
acute kidney obstruction
The study population will include 100 men and women that will be recruited during the
upcoming year, with a follow up of up to 3 months.
The study population will be divided into 2 groups:
1. The stone group: about 80 patients, aged 18-65, with normal creatinine for the past
year that presented in our ER because of renal colic, and their imaging shows a
ureteral stone.
2. The non-stone group: about 20 patients that present in our department for elective
surgery not related to stones or bladder outlet obstruction.
The stone group:
---------------- In the ER the patients will be examined, undergo blood and urine workup and
imaging as usual. If they are applicable according to our inclusion and exclusion criteria
and admitted and they will be included in our stone group. After signing an informed
consent, either as patients with a ureteral stone and normal creatinine or as patients with
a ureteral stone and an abnormal creatinine, Their urine sample will be sent for the urinary
markers: NGAL, KIM-1, ENdothelin and Cystatin C.
At this point it will be decided to admit or discharge them according to their clinical
imaging and laboratory findings, as acceptable. The admitted patients will be followed for
48 with additional blood and urine tests.
The admitted patients that will undergo renal drainage will be a specific subgroup in which
a selective urine test will be taken from the drained kidney
The non stone group:
-------------------- These are our control group from which we will take a single blood and
urine test before their elective surgery.
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Observational Model: Cohort, Time Perspective: Prospective
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