Renal function tests screening

Baseline laboratory tests should include complete blood cell count, prothrombin time, activated partial thromboplastin time, liver and renal function tests, and serum carcinoembryonic antigen (CEA). Serum CEA can serve as a marker for monitoring colorectal cancer response to treatment, but it is too insensitive and nonspecific to be used as a screening test for early-stage colorectal cancer. 

Dosing interval Preliminary evidence indicates that aminoglycosides may be administered on a once-daily basis without compromising efficacy and without increasing the potential for nephrotoxicity and ototoxicity. It is possible that the incidence of nephrotoxicity may even be decreased. Elderly Elderly patients may have reduced renal function that is not evident in the results of routine screening tests, such as BUN or serum creatinine. A Ccr determination may be more useful. 

Laboratory tests showed that hemoglobin was 7.5 g/dL (normal range is 12-15 g/dL), and the reticulocyte count was 262 x 109/L (normal range is 50-100 X 109/L). The tests also indicated neutrophilia, a white cell count of 34 X 109/L (normal range is 4-11 x 109/L), and a platelet count of 328 X 109/L (normal range is 150-400 X 109/L). Renal function was normal. Malarial parasite screen and direct Coombs test were negative. Blood film showed nucleated red blood cells and anisocytosis with bite cells ... 

While low serum cholesterol levels have been observed in malnourished patients, largely as a result of decreased synthesis of lipoproteins in the liver, hypocholesterolemia occurs later in the course of malnutrition and is therefore not useful as a screening test. PEM usually results in low serum urea nitrogen (BUN), urinary urea, and total nitrogen. Estimation of 24-h urine creatinine excretion is also a valuable biochemical index of muscle mass (when there is no impairment in renal function). The urinary CHI is correlated to lean body mass and anthropometric measurements. In edematous patients, for whom the extracellular fluids contribute to body weight and spuriously high body mass index values, the decreased CHI values are especially useful in diagnosing malnutrition. 

Microalbuminuria is defined as an increase in urinary excretion of albumin above the reference mterval for healthy nondiabetic subjects but at a concentration that is not generally detectable by crude clinical tests, such as dipsticks designed to measure total protein. With improved methodology, these low concentrations of albumin can now be measured, and microalbuminuria is now considered a clinically important indicator of deteriorating renal function in diabetic subjects. For example, it is now accepted by both European and U.S. diabetes societies that regular screening... 

Types of Animal Tests Tests done with animals often include general screening tests for pharmacologic effects, hepatic and renal function monitoring, blood and urine tests, gross and histopathologic examination of tissues, and tests of reproductive effects and carcinogenicity. 

Therefore, differences between properties of PTC in vivo in the normal adult kidney and in vitro properties of PTC and stem cell-derived proximal tubular-like cells may not just reflect dedifferentiation or lack of full terminal differentiation. Rather, altered marker expression patterns seem to be related to the biology of these cells and their response to altered conditions. It is important to keep in mind that human and animal PTC are probably always different under in vitro conditions (compared to the in vivo situation), unless the in vivo simation can be exactly mimicked. This is also important with respect to the interpretation of the differentiation status of stem cell-derived proximal tubular-like cells, as the expression of progenitor markers and markers specific for other renal cell types is normal under in vitro conditions, also in HPTC. For practical reasons we suggest to always compare stem cell-derived cells carefully to respective primary cells cultivated in vitro, which gives a realistic impression of the best possible differentiation state that can be achieved under the conditions used. In addition, rigorous functional tests (e.g., of transporter functions) are often more informative than marker expression patterns in terms of the applicability of stem cell-derived cells for drug screening. 

---