This article discusses the use of citrate anticoagulation during continuous renal replacement therapies (CRRTs) which are prescribed for patients with severe acute kidney injury (AKI). Where heparin was traditionally the anticoagulant of choice for CRRT, regional citrate anticoagulation (RCA) has now emerged as the...

This second of two articles on understanding the clinical value of measuring urea concentration explores the clinical value of simultaneous measurement of urea and creatinine and calculating the urea:creatinine ratio. The article discusses the causes of increased and decreased ratio as well as the clinical application ...

This first of two articles on understanding the clinical value of measuring urea concentration dives into the physiological topics, such as urea production and renal processing of urea as well as the causes of increased and reduced urea concentration. Kidney disease is associated with reduced urea excretion and...

The maintenance of blood pH within normal limits (7.35-7.45), called acid-base homeostasis, is a complex synergy involving three organs (lungs, kidneys and brain) as well as chemical buffers in blood and blood cells (erythrocytes). This vital physiologic process is the subject of a recent expert review article,...

Reprinted from Ann Lab Med 2014 Sep; 34(4):263-73. Procalcitonin (PCT) is used as a biomarker for the diagnosis of sepsis, severe sepsis and septic shock. At the same time, PCT has also been used to guide antibiotic therapy. This review outlines the main indications for PCT measurement and points out possible...

Disturbance of sodium balance is a common occurrence among hospitalized patients that can, if not identified and treated, cause significant morbidity; severe disturbance is potentially lethal. So estimation of plasma sodium concentration is one of the most frequently requested blood tests.  Historically, plasma sodium ...

Glomerular filtration rate (GFR) is a parameter of prime clinical significance because it defines kidney function. All those with reduced kidney function, no matter what the cause, have reduced GFR, and GFR correlates well with disease severity. The most accurate assessment of GFR is thus valuable not only for early...

The pH, base excess and pCO₂ (acid-base status) of arterial blood flowing through the umbilical cord provides valuable objective evidence of the metabolic condition of neonates at the moment of birth; a notion that has assured a role for the blood gas analyzer in hospital delivery suites in cases of suspected fetal...

Point-of-care testing (POCT) for key laboratory variables may help clinicians assess the level of acuteness and the level of care necessary in the management of deteriorating ward patients. We used a multibiomarker POCT panel including B-type natriuretic peptide (BNP), D-dimer, myoglobin (Myo), creatine kinase MB...

Recently developed high-sensitivity cardiac troponin (cTn) assays can measure approximately 10 times lower concentrations with high precision (coefficient of variation, <10 % at the 99th percentile of the upper reference limit) than conventional assays, and can measure cTn concentrations in at least 50 % of a reference ...