الفهرس 
Angiotensin Converting Enzyme inhibitorOnly 14 pages are availabe for public view
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Abstract
Background: Acute kidney injury (AKI) is generally characterized by sudden
deterioration in kidney function over a short period of time. Acute kidney injury is
common among intensive care unit (ICU) patients and is associated with high
mortality. There is a necessity for a novel biomarker of acute kidney injury with better
features than serum creatinine and urine output. Several investigations have
demonstrated that the fibroblast growth factor-23 (FGF-23) could be that desperately
searched novel biomarker of acute kidney injury. It cannot only detect kidney
dysfunction at the time but also before the injury process begins.
Subjects and Methods: This case- control descriptive analytical study was carried on
eighty (80) subjects with normal kidney functions at Fayoum University Hospitals
through the period from July (2018) till February (2019). All participants were
subjected to complete medical history, complete clinical examination, pelvi-
abdominal ultrasonography, urine analysis, blood sample for blood urea, serum
creatinine, CBC, Ca, PO4, uric acid and FGF-23.
Results: This study includes male to female ratio as 58%, 42 % in cases and 36.7%,
63.3% in controls respectively. The mean age of cases was 51.7±14.7 years and
46.5±8.2 years among controls. In our study 96% of cases had chronic illness. The
most common associated chronic illness were hypertension with cardiac disease and
hepatic disease by 27.1%and 25% respectively. The most common causes of ICU
admission were sepsis, cardiac catheterization and hepatic disease by 34%, 26% and
18% respectively. In the present study, there were hypotension, hypocalcaemia,
leukocytosis and anemia reported among cases. In this study 40% of cases show
elevation of serum creatinine level after 2 days of ICU admission and 60% were
increased in creatinine level after 5 days. 80% of cases had stage I AKI and 20% had
stage II AKI. The mean FGF23 level of cases was 1551.2±350.1 pg/ml compared to
94.6±24.1 pg/ml among controls. The mean serum creatinine level of cases at time of
admission was 0.85±0.10 mg/dl compared to 2.1±0.26 mg/dl after admission. The
mean GFR of cases at time of admission was 104.3±8.8 mL/min/1.73m 2 compared to
36.2±5.8 mL/min/1.73m 2 after admission.
Conclusion: It is concluded that FGF23 levels are elevated in AKI patients before
rising of serum creatinine. The role of FGF23 in chronic and acute illness needs to be
clarified. As FGF23 seems to be such a powerful and independent predictor of AKI, it
may become a useful routine disease marker for the identification of patients with the
highest risk for mortality and other complications.