Serum Cystatin C for the Diagnosis of Acute Kidney Injury in Patients Admitted in the Emergency Department.

Background: Early diagnosis of acute kidney injury (AKI) at emergency department (ED) is a challenging issue. Current diagnostic criteria for AKI poorly recognize early renal dysfunction and may cause delayed diagnosis. We evaluated the use of serum cystatin C (CysC) for the early and accurate diagnosis of AKI in patients hospitalized from the ED.

Diagnostic and prognostic utilities of multimarkers approach using procalcitonin, B-type natriuretic peptide, and neutrophil gelatinase-associated lipocalin in critically ill patients with suspected sepsis.

Background: We investigated the diagnostic and prognostic utilities of procalcitonin (PCT), B-type natriuretic peptide (BNP), and neutrophil gelatinase-associated lipocalin (NGAL) in critically ill patients with suspected sepsis, for whom sepsis was diagnosed clinically or based on PCT concentrations.

Methods: PCT, BNP, and NGAL concentrations were measured in 340 patients and were followed up in 109 patients. All studied biomarkers were analyzed according to the diagnosis, severity, and clinical outcomes of sepsis.

Fluid assessment and management in the emergency department.

Evaluation of hydration state or water homeostasis is an important component in the assessment and treatment of critically ill patients in the emergency department (ED). The main purpose of ED physicians is to immediately distinguish between normal hydrated, dehydrated and hyperhydrated states. Fluid depletion may result from renal losses and extrarenal losses (from the GI tract, respiratory system, skin, fever, sepsis, third space accumulations).

How to manage cardiorenal syndromes in the emergency room.

In the emergency department (ED) a prompt diagnosis and appropriate treatment for all diseases improve a patient's outcome. Acute kidney injury (AKI) is defined as an abrupt deficiency of renal function over a period of hours to days resulting in a failure of the kidney to excrete nitrogenous waste products and to maintain fluid and electrolyte homeostasis. AKI diagnosis could be very challenging for ED physicians because it is often very difficult to obtain some anamnestic data such as daily urine output or a preexisting value of BUN and serum creatinine.