الفهرس 
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Abstract
with the increasing use of radio-contrast media in diagnostic and interventional procedures over the last 30 years, Contrast-induced nephropathy (CIN) has become the third leading cause of hospital-acquired acute renal failure.Serum creatinine, the currently accepted ‘gold standard’ to diagnose AKI, is a delayed and inadequate marker of acute changes in renal function. In AKI, serum creatinine elevation that reflects the development and severity of kidney damage does not occur until days after renal tubular injury has Begun. CyC is excreted by glomerular filtration, then undergoes essentially complete tubular reabsorption and catabolism (without secretion), so that it is not normally found in urine in significant amounts. NGAL, a 25 kDa member of the lipocalin family, is markedly upregulated in the early postischemic mouse and rat kidney. Serum and urine NGAL levels are elevated earlier than serum creatinine in the setting of delayed graft function following kidney transplantation and percutaneous coronary intervention.Aim Of The Work: the aim of work is to study if plasma NGAL and plasma Cystatin C could be an early predictors of AKI after IV (high-osmolar) contrast media administration.Materials and methods:fifty patients were included in this study, they were divided into two main groups; Group(I) 25 patients underwent coronary angiography for dioagnostic and therapeutic purposes ,Group(II) 25 patients underwent computerized tomography using IV (high-osmolar) contrast media then classified after the operation to AKI group and NO AKI group according to the RIFLE criteria.Result:plasma NGAL measurement in patient with AKI shows a highly significant rise at 3and 6 hours after contrast administration from basal level. Plasma Cys C measurement in patient with AKI shows an non significant rise at 3 hours that become significantly at 6 hours after contrast administration from basal level. a statistically highly significant increase in the mean value of plasma NGAL and Cys C at 24 hour after contrast administration in patient with AKI compared with patients without AKI. serum creatinine show a statistical significant increase in patient with AKI compared with patient without AKI. the sensitivity and specificity of NGAL at 3h after contrast administration was 94.1% and 93.9% respectively. It was high in compared to plasma Cys C 54.7% and 72.7 % respectively.6 hour after contrast administration, NGAL sensitivity increased to 98.1% with slight decrease of the specificity to 91.9% , which was associated with increased Cys C sensitivity and specificity to 75.2% and 75.8% respectively. Conclusion: In conclusions, plasma NGAL and plasma Cystatin C maybe considered as early predictors of AKI after IV (high-osmolar) contrast media adminstration. using plasma NGAL basally and 3houres after IV (high-osmolar) contrast media adminstration as early renal biomarker of acute kidney injuery. using serum Cystatin C basally and 6houres after IV (high-osmolar) contrast media adminstration as early renal biomarker of acute kidney injuery. Further studies are recommended using large number of patient.