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Year : 2014  |  Volume : 4  |  Issue : 3  |  Page : 238-246

Bedside biomarkers in pediatric cardio renal injuries in emergency

Department of Pediatrics, Division of Pediatric Nephrology, Postgraduate Institute of Medical Education and Research Associated Dr. Ram Manohar Lohia Hospital, New Delhi, India

Correspondence Address:
Abhijeet Saha
Department of Pediatrics, Division of Pediatric Nephrology, Room no 406, PGIMER Building, PGIMER and Dr RML Hospital, New Delhi - 201 010
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2229-5151.141457

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Point of care testing (POCT) using biomarkers in the emergency department reduces turnaround time for clinical decision making. An ideal biomarker should be accurate, reliable and easy to measure with a standard assay, non-invasive, sensitive and specific with defined cutoff values. Conventional biomarkers for renal injuries include rise in serum creatinine and fluid overload. Recently, neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), cystatin C, interleukin-18 (IL-18) and liver fatty acid binding protein (L-FABP) have been studied extensively for their role in acute kidney injury associated with various clinical entities. Biochemical markers of ischaemic cardiac damage commonly used are plasma creatine kinase and cardiac troponins (cTn). Clinically valuable cardiac markers for myocardial injury in research at present comprise BNP/NT-proBNP and to a lesser extent, CRP, which are independent predictors of adverse events including death and heart failure. Current status of point of care biomarkers for diagnosis and prognostication of renal and cardiac injuries in pediatric emergency care is appraised in this review.

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