الفهرس 
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Abstract
Summary
Acute kidney injury (AKI) is a sudden loss of kidney function which results in the buildup of waste products in the blood and unbalanced body fluids. This condition has a rising incidence in the neonatal intensive care units (NICU).This disease is associated with high morbidity and mortality in neonates .
The early diagnosis of AKI is essential to introduce an appropriate and rapid therapeutic intervention to the patient, but the absence of sensitive and specific biomarkers has delayed disease detection due to the lack of anearly conclusive evidence of its occurrence. Common blood markers of kidney function, such as serum creatinine, are unspecific and insensitive to make a concrete resolution to initialize AKI therapy. Creatinine has limitations as a marker for renal function because of its slow rise after renal injury.
The aim of study is KIM-1 diagnostic value evaluation as a sensitive and specific biomarker for early AKI in neonates admitted to the NICU. the study was performed on 55 neonates admitted in NICU,35 neonate critically ill neonates and 20 healthy neonates as a control group .
All neonates admitted to the NICU were subjected to full history taking ,full clinical examination ,Daily follow up of vital signs, urine output , general examination and medications given to included neonates then duration of admission and outcome (discharge or death).
The following investigations were done: complete blood picture and C - reactive protein. serum creatinine levels at dayone, three and seven of admissionfor patient groups.Urine samples for KIM-1 level assessment was withdrawn from all neonates included patients at admission and another sample withdrawn at day 7 of admission
The study revealed the following results:
Urinary KIM 1 levels were significantly higher in patients than controls.At day 3 of admission, Urinary KIM-1 levels were significantly higher in patients with AKI compared to controls and patients without AKI (p value 0.002) , while there were no significant differences between patients without AKI and controls.
At day 7 of admission regarding the admission ,KIM-1 levels were significantly higher at day 7 (p value <0.001) ,while there were no significant difference in patients without AKI.Urinary KIM-1 was significantly higher in patients who had a deteriorating course of AKI than with improving course (p value <0.001)
The cutoff value of KIM-1 that can predict the development of AKI at day 3 was (>1.1)with 95%CI of sensitivity and specificity (84.21and100) respectively.
The cutoff value of KIM-1 that can predict the development of AKI at day 7 was (>1.1)with 95%CI of sensitivity and specificity (77.27and92.31) respectively.
There was a significant positive correlation between urinary KIM 1 levels and serum creatinine at day 7.