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Abstract
Background and objective: Cystic fibrosis (CF) is the most common life-limiting autosomal recessive disease among people in the USA and Europe with increased prevalence in Egypt. Pulmonary disease is the most important cause of morbidity and mortality in CF. Affected children are also in danger of acute kidney injury and the development of chronic renal disease through exposure to multiple potentially nephrotoxic agents including aminoglycosides, non-steroidal anti-inflammatory drugs (NSAIDs) and immune-suppressants. The aim of our study is to detect role of urinary N-Acetyl Beta -D- Glucosaminidase (NAGase) enzyme in early detection of renal impairment in cystic fibrosis patients. Results: Out of 40 children, (9 patients) 22.5% have normal NAG, (31 patients) 77.5% have high levels of NAG. There was significant diffirence between urinary N.A.Gase enzyme level in case and control children (P value < 0.001). G.F.R was done and (14 patients) 35% are abnormal. Serum creatinine and renal U/S were normal for all patients. There was significant Correlation between urinary N.A.Gase enzyme elevation and albumin/creat. ratio in urine , nephrotoxic drugs administration and duration of disease (P value = 0.002 , 0.005, 0.019 respectively ). Conclusion: In conclusion, our study confirms the presence of renal impairment among CF patients and that urinary N-Acetyl Beta -D- Glucosaminidase (NAGase) enzyme is a good early indicator of renal impairment in cystic fibrosis patients. Further studies with a larger sample size are needed to evaluate urinary enzymes as sensitive tools useful in the early diagnosis of acute renal injury before conventional laboratory assays become deranged in Egyptian patients with CF