Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

The aim of the study was to elucidate the role of plasma and urine NGAL as early marker of acute kidney injury in septic patients. Subject and methods: The study included 40 patients with severe sepsis and septic shock followed up clincially and by laboratory data then they divided into AKI group and NON AKI group according to the RIFLE criteria. Result :AKI was diagnosed in 17 patients (42.5 %) of the studied group. the current study found that patients with AKI had significantly higher frequency of positive isolated organisms when compared with patients without AKI. In respect to NGAL levels, we found significantly higher plasma and urinary NGAL levels at baseline and at 12 hour follow up period in patients with AKI when compared with patients without. In the present study regarding relation between serum and urinary NGAL values by timing of AKI showed that, serum NGAL at baseline and at 12 hour period values. they were higher among patients who had AKI at 12 hour; the mean measurement( 391.3, 259.3 ng/ml respectively ) (p=<0.001) than patients who developed AKI within 24 hour mean(202,286.5ng/ml respectively),whereas those who developed AKI within 48 hour had mean of( 164.8, 142.2ng/ml respectively). In our study both serum and urinary NGAL were a good predictor of AKI. The ability of serum NGAL at the baseline and 12hour follow up period to predict AKI in patients with sepsis showed AUC-ROC (0.82, 0.80 respectively), Sensitivity (82.4%, 82.4% respectively) and specificity (73.9%, 60.9% respectively).The ability of urinary NGAL at the baseline and 12hour follow up period to predict AKI in patients with sepsis showed AUC-ROC (0.79, 0.82 respectively), Sensitivity (76.5%, 60.9% respectively) and specificity (73.9%, 78.3% respectively)

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