الفهرس | Only 14 pages are availabe for public view |
Abstract Acute kidney injury is generally defined as ’an abrupt and sustained decrease in kidney function’. Acute Dialysis Quality Initiative (ADQI) formulated the Risk, Injury, and Failure, Loss, and End-stage Kidney (RIFLE) defines three grades of increasing severity of acute kidney injury - risk (class R), injury (class I) and failure (class F) - and two outcome classes (loss and end-stage kidney disease). It depends on serum creatinine and urine output as markers of renal function. Depending on traditional markers for renal functions, namely blood urea and serum creatinine, has lead to unacceptable delay in diagnosis and in initiating treatment. Our study aimed at depicting the role of KIM-1 as an early marker for AKI. The present study included 89 subjects that have been classified into 3 groups: Group 1: 44 critically-ill patients who developed AKI. Group 2: 35 critically-ill patients who didn’t develop AKI Group 3: 10 healthy subjects were taken as control. Both patients & control groups in the study have been subjected to thorough history taking, complete clinical examination, routine laboratory investigations including full blood count, fasting blood sugar, liver profile, ESR, arterial blood gases, electrolytes, pelvi-abdominal ultrasonography and urinary KIM-1. Summary - 93 - Blood urea, serum creatinine and urinary KIM-1 were withdrawn from all patients at admission, then at time of admission & 6 and 12 hours intervals. The results of this study may be summarized as follows: • KIM-1 can detect acute kidney injury as early as 6 hours from its occurrence and before elevation of the conventional markers by 48 hours at least. • KIM-1 is ( unlike the conventional markers ) not influenced by age, sex and body mass index. • KIM-1 is a reliable indicator of morbidity and mortality in critically ill patients. • KIM-1 after 6 hours has a sensitivity of 100% and a specificity of 97.1%. • KIM-1 after 12 hours has a sensitivity of 100% and a specificity of 100%. |