Biomarkers of paracetamol intoxication and detoxication

The metabolic basis of paracetamol hepatotoxicity was elucidated over 25 years ago 5 . Figure 17.2 illustrates the kinetic changes in paracetamol disposition that underlie the development of liver damage. These principally involve the rate and extent of production of a reactive metabolite, N-acetyl-p-benzoquinoneimine (NAPQI), in amounts that exceed the capacity for detoxication by conjugation with GSH. The formation of paracetamol sulphate and glucuronide conjugates represent pathways that...

Anaemia and renal failure

Anaemia is an important complication of renal failure as a result of the loss of the capacity to synthesize erythropoietin. However, iron deficiency is also an important cause of erythropoietin resistance. While ferritin is a good marker of iron status, this is less true in patients with a chronic disease such as renal failure. An alternative proposed marker is soluble transferrin receptor, the level of which is influenced by iron status but not the coexistence of chronic disease. Daschner and...

Cystic kidney diseases

Autosomal dominant PKD is the prototype, and by far the most prevalent, inherited cystic kidney disease. Diagnosis is based mainly on renal ultrasonographic findings, in at-risk subjects belonging to ADPKD families 4 . Normal renal ultrasonography after 30 years of age excludes the diagnosis, but this is not true for younger subjects. Genetic diagnosis may therefore be required in rare instances (i) when living related kidney donation is considered in at-risk subjects aged less than 30 years...