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Carbamylated Hemoglobin can Differentiate Acute Kidney Injury from Chronic Kidney Disease

Y Naresh1, N Srinivas1, Kiranmayi S Vinapamula1

  • 1Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.

Indian Journal of Nephrology
|July 3, 2018
PubMed

Insights

Carbamylated hemoglobin (CarHb) can help distinguish acute kidney injury (AKI) from chronic kidney disease (CKD). Elevated CarHb levels in patients with kidney disease suggest its diagnostic potential for differentiating these conditions.

Area of Science:

  • Nephrology
  • Biochemistry
  • Clinical Diagnostics

Background:

  • Acute kidney injury (AKI) and chronic kidney disease (CKD) often present with similar clinical symptoms.
  • Differentiating between AKI and CKD is crucial for appropriate patient management and treatment strategies.
  • Carbamylated hemoglobin (CarHb) has emerged as a potential biomarker in renal disease research.

Purpose of the Study:

  • To evaluate the diagnostic performance of CarHb in differentiating AKI from CKD.
  • To assess the clinical utility of CarHb as a biomarker in patients with renal disease.
  • To determine a specific cut-off value for CarHb to distinguish between AKI and CKD.

Main Methods:

  • Inclusion of 40 patients with renal disease (AKI or CKD) and 20 healthy controls.
  • Measurement of urea, creatinine, hemoglobin (Hb), and CarHb levels in all study participants.
  • Statistical analysis including correlation, sensitivity, specificity, and receiver operating characteristic (ROC) curve analysis.

Main Results:

  • Significantly elevated CarHb levels were observed in both AKI and CKD patients compared to healthy controls (P < 0.05).
  • CKD patients exhibited significantly higher CarHb levels than AKI patients (P < 0.05).
  • CarHb showed a strong positive correlation with urea (r = 0.776, P < 0.0001) and an AUC of 0.840 (P < 0.0001).

Conclusions:

  • CarHb is a promising biomarker for differentiating between AKI and CKD.
  • A CarHb cut-off value of 98.33 μg VH/g Hb demonstrated optimal sensitivity (85%) and specificity (75%) for distinguishing AKI from CKD.
  • CarHb measurement can aid clinicians in managing patients with overlapping renal disease presentations.

Keywords:
Acute kidney injurycarbamylated hemoglobinchronic kidney disease

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