الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Acute kidney injury (AKI) is common and the absolute incidence of AKI has increased during the last decade. AKI is emerging as a public health problem since epidemiologic studies reveal that mild increases in SCr of hospitalized patients are associated with increased morbidity and mortality. Between 5% and 40% of critically ill patients in the intensive care unit (ICU) have an episode of AKI. Up to 4.9% of critically ill patients in the ICU will require renal replacement therapy. AKI requiring renal replacement therapy in the ICU has a high mortality of over 50%. The commonest causes of AKI are septic shock, ischemia and nephrotoxins. AKI is defined by acute changes in SCr, which is a known late and non-specific marker of AKI . Thus, it is necessary to discover several urinary protein biomarkers have been identified as potential candidates for AKI detection prior to SCr rise. Our study included 84 heterogenous critically illpatient admitted in ICU. The patients were classified into 2 groups :• AKI group : The creatinine level was elevated either by 25% of the basal level or by ≥0.3mg/dl above the basal level after 24 hours. this group included 36 patients, 22 were males and 14 were females. No AKI group : rise of the serum creatinine level less than 0.3mg/dl above the basal level after 24 hours. this group included 48 patients, 31 were males and 17 females. All subjects of this study were subjected to full clinical examination, routine laboratory investigations including urine analysis, complete blood picture, liver function tests, kidney function tests, calculation of glomerular filtration rate using MDRD equation, random blood sugar and pelvi abdominal ultrasound . Measurement urinary IL-18 was done by ELISA method in critically illpatients in ICU. Urinary IL-18 was significantly increased in AKI group after 6 hours compared to its basal values./dl)Further increase of urinary IL-18(pg/dl) after 24 hours compared to both basal and 6 hours values.
This study also revealed that urinary IL-18 was higher in patients with AKI compared to patients without AKI.Serum cr.(mg/dl) was not elevated in either groups AKI and non AKI after 6 hours.Serum cr.(mg/dl) was significantly increased in AKI after 24 hours.
This study showed high significant correlations between 6h and 24h urinary IL-18(pg/dl) and both; basal serum creatinine (mg/dl) and basal urinary IL-18(pg/dl), associated with statistical significant correlations with GFR according to MDRD (ml/min) in the AKI group which meaning significant correlations between urinary IL-18 with serum creatinine and MDRD. We found that the sensitivity and specificity of urinary IL-18 at 6h from admission in ICU was 91.1% and 93.9% respectively.