Table of Contents
ISRN Nephrology
Volume 2014, Article ID 376795, 7 pages
http://dx.doi.org/10.1155/2014/376795
Research Article

Urinary Biomarkers of Acute Kidney Injury in Patients with Liver Cirrhosis

1Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt
2Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt
3Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt

Received 21 February 2014; Accepted 12 March 2014; Published 6 April 2014

Academic Editors: J. Almirall, F. Artunc, and C. G. Musso

Copyright © 2014 Anass Ahmed Qasem et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute kidney injury (AKI) is a common complication in cirrhotic patients. Serum creatinine is a poor biomarker for detection of renal impairment in cirrhotic patients. This study aimed to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary interleukin-18 (IL-18) as early biomarkers of acute kidney injury in cirrhotic patients. 160 patients with cirrhosis admitted to the Liver Units at Zagazig University Hospitals were classified into three groups: (I) nonascitic patients, (II) ascitic patients without renal impairment, and (III) ascitic patients with renal impairment. Patients with renal impairment were further divided into four subgroups: [A] prerenal azotemia, [B] chronic kidney disease (CKD), [C] hepatorenal syndrome (HRS), and [D] acute tubular necrosis (ATN). Significant elevation of both urinary NGAL and urinary IL-18 in cirrhotic patients with renal impairment especially in patients with ATN was observed. Urinary NGAL and urinary IL-18 have the ability to differentiate between AKI types in patients with cirrhosis. This could improve risk stratification for patients admitted to the hospital with cirrhosis, perhaps leading to early ICU admission, transplant evaluation, and prompt initiation of HRS therapy and early management of AKI.