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Abstract
This study was done to illustrate the incidence of septic and non septic acute renal failure in patients admitted to Alexandria main university hospitals. 170 patients were seen in Alexandria University Hospitals over a period of six months 58.2 % of the patients were diagnosed as CKD (First presentation) and they were excluded from the study (99 patients) 41.8% of the patients were included in the study (71 patients)
There were 3 main categories of diagnosis: AKI group 57.7% (41 patients): 19 Female and 22 Male, median age = 45 (Range from 14 -83) Acute on top of CKD group 25.4% (18 patients):12 Female and 6 Male, median age =57 (Range from 18 – 75) GN group 16.9% (12 Patients):8 Female and 4 Male, median age = 34 (Range from 14 – 67)
The distribution of the patients according to prognosis was as the following: 35.2% Died, 25.4% CKD, 16.9% ESRD, 16.9%Recovered, 5.6%Unknown.
As regard sepsis, 42.25% of the patients (30 patients) were septic while 57.75% of the patients were non septic. 46.7% (14 patients) of the septic group died.
Serum creatinine and other routine laboratory investigations were done in all patients (even the group of CKD)
Urinary NGAL was measured in 20 patients and 18 healthy controls. Urinary NGAL was significantly higher in the patient group. Urinary NGAL was strongly correlating with the serum creatinine although this was of no statistical significance. There was no statistically significant difference between the level of uNGAL in the different groups of diagnosis. There was no statistically significant difference between the level of uNGAL in the different groups of prognosis. uNGAL level in the septic patients was higher than that in the non septic patients but this was of no statistical significance.
Serum Procalcitonin was measured in 25 patients (including the 20 patients in whom the uNGAL was measured) 9 patients were septic while 16 were non septic. Serum Procalcitonin was significantly higher in the septic patients than that in the non septic patients. The serum Procalcitonin level was the highest in the group of septic patients who died (with exception to the unknown group) but this was of no statistical significance.
The correlation between serum creatinine and serum procalcitonin is weak and insignificant preserving the diagnostic capability of procalcitonin as a marker of sepsis even in the setting of AKI , also the correlation between uNGAL and serum procalcitonin is weak and of no statistical significance.
from the fact that procalcitonin is a well established marker for sepsis and the weak correlation between urinary NGAL and serum Procalcitonin we can conclude that uNGAL is indeed unique for AKI regardless of sepsis.