1.Use of beta 2 microglobulin as a kidney function marker
Narantuguldur D ; Khulan P ; Taikhar B ; Naranmandakh G ; Ariunbold J
Health Laboratory 2020;12(2):23-27
Purpose:
Kidney function assessment method is improving gradually. New biomarkers are studied and started using in clinical practice, such as beta 2 microglobulin. Beta 2 microglobulin is improving diagnostic and prognosis in CKD patients. We aimed to assess convenience usage of B2MG alone and B2MG based eGFR in Mongolian patients.
Materials and method:
We included 116 patients diagnosed with CKD and 55 donors whom with normal kidney function.
We collected participant's blood sample by venipuncture in plain vacutainer. Creatinine, urea, cystatin C, B2MG were tested by Roche Cobas C311 equipment in serum. eGFR was calculated by online calculation from NKF. B2MG based eGFR was calculated by eGFR=133*B2M-0.852
Result:
Assessment of kidney biomarkers and eGFR was significantly correlated in both groups. Measured serum creatinine was 3.37 mg/dl in CKD patients and 0.87 mg/dl in donors. Serum urea was 97.6 mg/dl, 31.1 mg/dl, cystatin C 3.05 mg/L, 1.49mg/L and beta 2 microglobulin 10.65 mg/L, 2.43 mg/L respectively. Estimated GFR was 21.5-28.4 ml/min/1.73m2 in CKD patients and 47.7-103.9 ml/min/1.73m2 in donors.
Assessing kidney function by biomarkers (r=0.720-0.918, p<0.05), and eGFR (r=0.495-0.996, p<0.05) were significantly correlated in both groups.
Conclusion
B2MG can be used in clinical practice in Mongolia. B2MG is optional with creatinine, urea, cystatin C for assessing and improving kidney function.
2.Significance of evaluation of D-dimer in COVID-19 patient: Case report
Bayarjavkhlan Ch ; Battulga Ch ; Buyanjargal E ; Byambalkham B ; Jargal-Erdene B ; Naranmandakh D ; Munkhsaikhan B ; Munkhbat T ; Oyungerel S ; Enkhnomin O ; Gantuya L ; Ulziitsetseg Ts
Health Laboratory 2021;14(2):23-32
Introduction:
Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis.
Objective:
We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy.
Case report:
We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved.
Conclusion
The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.