الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Despite the absence of age-related comorbidities, ageing is linked to notable alterations in the kidney’s structure and function. Additionally, as people age, their muscle mass decreases. As a result, aged people’s plasma creatinine levels may be lower than normal, obscuring an increase in kidney damage and potentially delaying or postponing the detection of AKI.
AKI was defined as the rising of serum creatinine (equal to or more than 0.3 mg/dl) within 48 hours or the rising of serum creatinine by equal to or more than 50% or urine volume less than 0.5 ml/kg/h for 6 hours. AKI is observed in 10–15% of hospital admissions and over 50% of ICU admissions.
The incidence of AKI is 21% in people worldwide, and the death rate is 23%. AKI is becoming more prevalent in older people, who are generally considered to be those who are older than 65 years of age, according to numerous studies.
Sepsis is a life-threatening organ dysfunction due to an impaired host response to infection which can be represented clinically by an increase in the qSOFA score of two points or more; however, septic shock is a subgroup of sepsis that is characterized by extensive circulatory and metabolic abnormalities and has a higher risk of mortality than sepsis alone.
Several trials have assessed the usefulness of various biomarkers in the early detection and risk assessment of AKI. TIMP-2 and IGFBP7 are two of these indicators. Both are produced and released by renal tubular cells and implicated in G1 cell cycle arrest during the early stages of cellular stress or injury caused by diverse stressors.
The study attempted to assess the Predictive and diagnostic value of these biomarkers for acute kidney injury in elderly Egyptian patients with sepsis.
The study was performed in Alexandria Main University Hospital, Intensive Care Unit and Internal Medicine Department, Geriatric Unit. The study was performed on 150 patients. All patients aged 65 years or older had sepsis (qSOFA score of two points or more and evidence of infection). Patients with CKD, a history of renal transplantation, patients admitted with Acute Kidney Injury, and with hospital stays less than 24 hours were excluded
All patients included in the research were subjected to history taking, physical examination, Ultrasound renal assessment, and laboratory investigations such as CBC, CRP, urine analysis serum albumin, procalcitonin, blood urea and serum creatinine, serum electrolytes, estimation of GFR by MDRD and the urine was analyzed for urinary TIMP-2 and IGFBP7 within the first 24 hours of admission and between 48 and 96 hours of admission using Enzyme-linked Immunosorbent Assay (ELISA) Technique.
There was a statistically significant association between TIMP-2 and IGFBP7 for prediction of the AKI and can be used for early detection and diagnosis of AKI in septic elderly Egyptian patients with p<0.001
Additional researches are needed to assess the prognostic factors of these markers for AKI in elderly patients with sepsis and its applicability in clinical practice