COVID-19 Management of Kidney Injured Patients – CKD & AKI
COVID-19 Management of Kidney Injured Patients – CKD & AKI
COVID-19 Management of Kidney Injured Patients
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Randox CKD & AKI Array’s
COVID-19 Management of Kidney Injured Patients
- Simultaneous and quantitative detection of multiple kidney function markers from a single patient sample for complete patient profiling
- Identify early stage renal impairment and improve patient risk stratification
- Unique combination of analytes ensures better sensitivity and accuracy compared to traditional serum creatinine measurement
- Monitor the effectiveness of treatment in COVID-19 patients
- Arrays available for identifying and monitoring both acute and chronic renal impairment
- Utilising patented Biochip Technology, both arrays are currently available on the Evidence Investigator
Analysis of COVID-19 patients revealed that Acute Kidney Injury (AKI) is common and associated with a very high mortality rate highlighting the need for more accurate patient testing. Further to this the National Institute for Health and Care Excellence (NICE) recommend that all COVID-19 patients are assessed for AKI on admission to hospital and their condition monitored throughout their stay. The complications with serum creatinine measurement alone for the detection of impaired kidney function are well known. To address this issue, Randox have developed three multi marker kidney function arrays for early detection of renal impairment. Individuals with pre-existing kidney injury are at an increased risk of COVID-19, those with severe CKD (stages 3-5) are at a higher risk of complications.
Utilising patented Biochip Technology, the Randox Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI) arrays could improve COVID-19 risk stratification whilst monitoring the effectiveness of treatment.
Randox Chronic Kidney Disease (CKD) Array I (7-plex)
EGF regulates renal cell proliferation, fibrosis and inflammation and is produced in response to renal injury.
IL-8 endothelial-derived chemokine involved in recruiting neutrophils to sites of injury and stimulating their response.
sTNFR1 is used to identify an increase in inflammatory conditions such as CKD.
FABP1 binds long-chain fatty acids, contributing to reducing oxidative stress in the kidneys.
sTNFR2 is used to identify an increase in inflammatory conditions such as CKD.
D-Dimer is a fibrin degradation product, and an index of both coagulation and fibrinolysis.
MIP-1 alpha plays a roles in inflammatory responses at sites of injury or infection.
Randox Chronic Kidney Disease (CKD) Array II (4-plex)
CRP is an acute phase reactant involved in inflammation.
Cystatin C is well recognised marker of kidney filtration dysfunction and injury.
C3a des Arg is a representative of complement component C3a which produces local inflammatory responses.
NGAL is among the current state-of-the-art in CKD biomarkers.
Randox Acute Kidney Injury (AKI) Array (4-plex)
This marker is highly upregulated in kidney tubule cells following nephrotoxic injury severe enough to result in acute renal failure, acute tubular necrosis or acute tubulo-interstitial nephropathy.
Due to its small size and basic pH, Cystatin C is freely filtered by the glomerulus. It is then reabsorbed by tubular epithelial cells and subsequently metabolized. Accumulation of Cystatin C in urine is specific for tubular kidney damage and suggests reduced reabsorption at the proximal tubules as a result of toxicant-induced kidney injury.
Expression of Clusterin is upregulated following a variety of renal injuries and is detectable in urine following acute kidney injury induced by administration of nephrotoxic agents. This occurs before the profound renal transformations that give rise to changes in creatinine and BUN.
KIM-1 is a 30kDa type 1 transmembrane glycoprotein found on actvated CD4+ T cells. It is undetectable in healthy kidney tissue but is expressed at very high levels in proximal tubule epithelial cells in the kidney after toxic injury.
The Evidence Investigator
Meet the Evidence Investigator
The Randox CKD & AKI arrays have both been developed for the Evidence Investigator, a semi-automated benchtop immunoassay analyser.
The CKD & AKI array’s would improve COVID-19 risk stratification whilst monitoring the effectiveness of treatments by simultaneously and quantitatively detecting multiple serum biomarkers of kidney damage-related analytes from a single sample.
Want to know more?
Contact us or visit our Investigator Webpage
Alzheimer’s Disease Array
Randox ApoE4 Array (EV4113)
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Rapid Identification of Alzheimer’s Disease Risk
Rapid Identification of Alzheimer's Disease Risk
- Identification of Alzheimer’s disease risk in under 3 hours
- Direct determination of ApoE4 status from a plasma sample eliminates the need for molecular genotyping
- Potential to improve quality of life and care for dementia patients through lifestyle and therapeutic interventions
- Patented Biochip Array Technology simultaneously measures total ApoE and ApoE4 protein levels directly from a plasma sample
- 100% concordance with molecular genotyping
- Applicable to Alzheimer’s research, personalised medicine and the development of Alzheimer’s therapeutics
The Randox ApoE4 Array is a rapid and highly sensitive blood test facilitating direct ApoE4 genotyping without the need for molecular genotyping. ApoE exists as three common isoforms; ApoE2, ApoE3 and ApoE4. As such, six common ApoE genotypes exist in the general population. Alzheimer’s Disease risk is significantly increased in individuals with the ApoE4 allele. The below table provides an indication of risk associated with the six common ApoE genotypes.
Biomarkers Tested
ApoE is a major cholesterol carrier, responsible for lipid homeostasis by mediating lipid transport from one tissue or cell type to another. In the central nervous system, ApoE is mainly produced by astrocytes, and transports cholesterol to neurons via ApoE receptors. ApoE exists as three common isoforms; ApoE2, ApoE3 and ApoE4.
ApoE4 is established as the strongest genetic risk factor for Alzheimer’s Disease. ApoE4 triggers inflammatory cascades that cause neurovascular dysfunction, including blood-brain barrier breakdown, leakage of blood-derived toxic proteins into the brain and reduction in the length of small vessels.
Apo E4 is one of three common isoforms of Apo E and is recognised as a major genetic risk factor the development of Alzheimer’s disease. Apo E4 triggers inflammatory cascades that cause neurovascular dysfunction, including blood-brain barrier breakdown, leakage of blood-derived toxic proteins into the brain and reduction in the length of small vessels.
The Evidence Investigator
Meet the Evidence Investigator
The Randox ApoE4 Array (EV4113) is a research use-only product developed for the Evidence Investigator, a semi-automated benchtop immunoassay analyser.
The ApoE4 Array (EV4113) simultaneously measures both total ApoE and ApoE4 protein levels directly from a plasma sample. The Apo E4/total ApoE ratio can classify the ApoE4 status of the plasma sample as negative or positive. Furthermore, the Array has demonstrated potential to classify ApoE4 positive plasma samples as being derived from a heterozygous (one copy of ApoE4 gene) or a homozygous (two copies of ApoE4 gene) individual. Therefore, risk for the development of Alzheimer’s Disease can be assessed.
Publications
Want to know more?
Contact us or visit our Cerebral Array webpage.
Alzheimer’s Disease testing on the Randox Evidence Series
What is Alzheimer’s Disease?
Alzheimer’s Disease is a progressive disease and is one of the most common kinds of dementia.
Our brains are made up of billions of tiny nerve cells which connect to each other. However, if you have Alzheimer’s Disease the connections between the cells are lost, which results in the loss of brain tissue and causes nerve cells to die1.
The brain is responsible for sending signals between cells. Those who suffer with Alzheimer’s have less ‘chemical messengers’ in their brain, so the signals are not passed on as well1.
The statistics of those who suffer with dementia is increasingly high and the figure is set to rise in the foreseeable future. Over 850,000 people are living with dementia in the UK. Studies states that one million people in the UK will have dementia in 2025 and this will increase to two million by 2050.2
Symptoms of Alzheimer’s Disease
The symptoms of Alzheimer’s disease are divided into 3 main stages; early symptoms, middle-stage symptoms and later symptoms.
In the early stages, the main symptom of Alzheimer’s disease is memory lapses which can increase anxiety or agitation. In the early stages, it is often mistaken that the person is forgetful and aren’t aware they are suffering with Alzheimer’s. The typical signs are listed below:3
- forget about recent conversations or events
- misplace items
- forget the names of places and objects
- have trouble thinking of the right word
- ask questions repetitively
- show poor judgement
- become less flexible and more hesitant to try new things
As the disease progresses, the symptoms will gradually get worse. Memory problems will get worse which can make it difficult for the person who suffers with the disease to remember names of their loved ones, recent events and even remember birthdays and anniversaries. More symptoms such as the following will develop;3
- increasing confusion and disorientation – for example, getting lost, or wandering and not knowing what time of day it is
- obsessive, repetitive or impulsive behaviour
- delusions or feeling paranoid and suspicious about carers or family members
- problems with speech or language
- disturbed sleep
- changes in mood
- difficulty performing simple tasks and may need additional support e.g. help with eating, getting dressed etc.
In the later stages of Alzheimer’s disease, the symptoms become increasingly severe and patients will need full-time care and assistance. It will be problematic for the individual to do basic everyday tasks such as getting changed, going to the toilet, getting washed and feeding themselves. They could lose their speech, and have difficulty eating and swallowing which can result in severe weight loss.
How Randox can help
Randox want to help. Our Evidence immunoanalyser has revolutionised laboratory screening worldwide with the capability to process 3,960 tests per hour and a sample capacity of 360. We offer the Apolipoprotein E4 (ApoE4) Array for Alzheimer’s genetic risk assessment, which is a research use-only product developed for the Evidence Investigator. The ApoE4 Array measures both total ApoE protein levels and ApoE4 protein levels directly from plasma samples and using a ratio can classify patients as negative or positive for ApoE4. In turn we can then assess their risk for the development of Alzheimer’s disease.
For further information about the Randox Alzheimer’s Array or our Evidence Investigator, please email info@randoxbiosciences.com
Randox Alzheimer’s Array on the Evidence Investigator
Alzheimer’s disease
Alzheimer’s disease is the most common cause of dementia. It is defined as an irreversible, progressive brain disorder, in which parts of the brain are damaged over time. As this happens symptoms develop, but also get worse.
Dr. Alois Alzheimer discovered that in Alzheimer’s disease the connections between the cells and brain tissue are lost because proteins build up and form abnormal structures called “plaques” and “tangles”. 1 A healthy brain contains important chemicals which send signals between the cells, however, those who suffer with Alzheimer’s have less “chemical messengers.” Therefore, the signals don’t get passed on. 1
Risk factors
Age is the biggest risk factor. Alzheimer’s disease is more common amongst older adults. In the UK there are over 40,000 people under the age of 65 who suffer with some form of dementia. 2 Studies also state that women over the age of 65 are twice as likely to develop Alzheimer’s disease than men – although there is no clear evidence as to why.
There are two different types of Alzheimer’s. The early on-set variant of the condition is very uncommon but strikes people younger than 65. Often people with early-onset Alzheimer’s develop symptoms in their 40s or 50s. Whereas, late-onset Alzheimers is more common and affects people age 65 and older. 2
Symptoms
The disease slowly destroys memory and thinking skills. The earliest symptoms are memory lapses where they may struggle to remember recent events or learn new information, or even forget important items for day-to-day life for example, their keys, glasses or mobile phone. Memory loss due to the disease can increasingly interfere with their life as often the ability to carry out simple tasks can become a struggle. As a result, the person suffering can become anxious, irritable and can even be depressed.
In the later stages of Alzheimer’s, the symptoms become more severe. The individual will become less aware of what’s happening around them. They may have difficulties eating, walking and will require additional help and support with their daily activities from their loved ones or from a carer.
Unfortunately, there is no cure for Alzheimer’s Disease, although, there is treatment that can help manage the symptoms.
The Randox Apolipoprotein E4 Array
Randox offers The Apolipoprotein E4 (ApoE4) Array.
The Apolipoprotein E4 (ApoE4) Array is a research use-only product developed for the Evidence Investigator, which is a semi-automated benchtop immunoassay analyser which can process up to 2376 test per hour as well as up to 44 analytes screened per biochip.
The ApoE4 Array measures both total ApoE protein levels and ApoE4 protein levels directly from plasma samples and by using a ratio it can classify patients as negative or positive for ApoE4. In turn we can then assess their risk for the development of Alzheimer’s disease.
For further information about the Randox Alzheimer’s Array or our Evidence Investigator, please email info@randoxbiosciences.com
- https://www.alzheimers.org.uk/about-dementia/types-dementia/alzheimers-disease-symptoms
- https://www.nia.nih.gov/health/what-alzheimers-disease
Assessing the risk of developing Alzheimer’s disease
World Alzheimer’s Month
World Alzheimer’s Month is a global campaign to raise awareness and highlight the challenge that surrounds the disease, hosted by the Alzheimer’s disease International (ADI) every September. During this month World Alzheimer’s Day also takes place, 21 September each year.
47 million people are living with Alzheimer’s worldwide, costing 604 billion USD per year. This number is expected to rise to 76 million people with the disease by 2030.1 The FDA have not approved a medication for the treatment of Alzheimer’s disease since 2003. More than 400 clinical trials are currently looking at new treatments for Alzheimer’s disease (AD) and many of them are actively recruiting. Many still regard the amyloid hypothesis as a key explanation for Alzheimers disease development and progression.2
Alzheimer’s risk
Alzheimer’s disease is not necessarily inherited as a single-gene mutation as the inheritance pattern is incredibly complex. Unlike familial Alzheimer’s disease, a multi-gene form usually affects those aged 65 and older. The gene with the greatest known effect on the risk of developing late-onset Alzheimer’s disease is called apolipoprotein E (APOE). It is found on chromosome 19 and the APOE protein plays a role in handling fats in the body, including cholesterol. 3
ApoE plays a key role in lipid metabolism and the scientific and medical community recognise it as one of the most powerful genetic risk factors for dementia and other neurodegenerative diseases. It has become one of the most widely studied gene variants in Alzheimer’s disease and constitutes a major consideration for preventive medicine.
ApoE exists in three common isoforms (ApoE2, ApoE3 and ApoE4) which are coded by three co-dominant alleles (e2, e3, e4). As such, six common ApoE phenotypes exist within the general population: E2/E2, E3/E3, E4/E4 (homozygous) and E2/E3, E2/E4, E3/E4 (heterozygous). Medical professionals recognise the presence of the ApoE4 isoform as a major genetic risk factor for development of Alzheimer’s disease. Therefore, the availability of analytical methods for rapid and reliable ApoE4 classification is advantageous.
Evidence Investigator
The Apolipoprotein E4 (ApoE4) Array is a research use only product developed for the Evidence Investigator. The ApoE4 Array measures both total ApoE protein levels and ApoE4 protein levels directly from plasma samples and using a ratio can classify patients as negative or positive for ApoE4. In turn we can then assess their risk for the development of Alzheimer’s disease.
2-plex Biochip Array
- Pan ApoE
- ApoE4
An individual’s ApoE status has been shown to affect pre-symptomatic risk, diagnosis, prognosis, and treatment response for a variety of diseases, in particular Alzheimer’s disease. The ApoE4 Array can rapidly and accurately detect an individual’s ApoE4 status directly from a plasma sample. In combination with medical and family history, medication and lifestyle, this can deliver valuable information for personalised medicine approaches.
The 2-plex diagnostic Alzheimer’s test has the utility to detect the likelihood of a person’s chance of developing the disease to assist in the research and development of a potential drug to combat or slow down the process of Alzheimer’s.
1 https://www.alz.org/global/overview.asp
2 https://www.brightfocus.org/alzheimers/article/clinical-trials-alzheimers-disease-whats-new
For further information about the Randox Alzheimer’s Array, please email info@randoxbiosciences.com
