A new biomarkir in differential diagnosis of acute and choronic renal failure: Hyaluronic acid

Introduction: It may be difficult to differentiate acute from chronic failure in cases with no past medical reports of renal function. Herein, we aimed to investigate the role of serum hyaluronic acid (HA) which is known as a marker of fibrosis, in differential diagnosis of renal failure.Materials and Methods: A total of 90 patients (52 females and 38 males) admitted to our renal unit with uremia for the fist time was included. Serum HA level was measured with corgenix Hyaluronik Asit Test. The diagnostic role of the test was investigated by student t-test, Pearson correlation and ROC curves.Results: The mean age of patients was 54.6 ±17.9 years. The final diagnosis was chronic renal failure (CRF) in %41.1, acute renal failure (ARF) in 48.9%, acute on CRF in % 6.7 of patients. Three patients died prior to differential diagnosis. The mean serum HA was significantly higher in CRF group (146.1± 119.3 ng/ml) than ARF group (68.9 ± 69.1 ng/ml) (p<0.0001). There was a positive significant correlation between serum HA level and the daily amount of proteinuria (r=0.716, p<0,0001) and a negative significant correlation between serum HA level ant serum albumin level (r=- 0.544, p<0,0001). Serum HA level at a cutoff set at 61 ng/dl has a sensitivity of 82% and specificity of 67% for differential diagnosis of ARF and CRF.Conclusion: Serum hyaluronic acid level may be useful in differential diagnosis of renal failure and further larger studies are warranted to clarify the definite role of this test.