PURPOSETo validate serum neutrophil gelatinase-associated lipocalin (NGAL) as an early biomarker for acute kidney injury (AKI) in sepsis-related conditions and its predictive and prognostic values.PATIENTS AND METHODSThis study included 65 patients, who were clinically evaluated for sepsis, severe sepsis, or septic shock, and 20 apparently healthy served as controls. Patients were divided into two groups: Group I (AKI-sepsis): 65 newly admitted patients diagnosed as sepsis, who were further divided into three subgroups according to the severity: systemic inflammatory response syndrome, severe sepsis, and septic shock, and Group II (control group): 20 apparently healthy subjects matched for age and sex, serum creatinine and serum NGAL concentrations were estimated initially within 24 hours of admission and after 72 hours of admission in all patients and control groups.RESULTSSerum NGAL increased significantly with increasing severity of renal impairment. Receiver-operating characteristic analysis suggested that serum NGAL cutoff value of 40 ng/mL within the first 24 hours of admission is highly specific and sensitive for predicting AKI, with sensitivity of 90.9% and specificity of 75.8%.CONCLUSIONWe concluded that early measurement of serum NGAL level in sepsis can serve as a clinically useful marker for early prediction of AKI and for grading of its severity.

Background: Silica (SiO2), an abundant mineral found in sand, rock, and soil is an increasingly identified environmental nephrotoxin with fairly unique renal and systemic manifestations. Aim: To identify the relation between silica exposure among marble workers and renal diseases in order to early predict renal affection. Materials & Methods: This study was conducted in marble blasting area in El Maadi, in Cairo. The studied group included 25 workers in the marble blasting area. They were adult men aged between 18-42 years (26.5±7.8), working on the basis of 10 hours/day with one day off per week. A referent group of 40 males matched for age (that ranged from 21-41 yrs., 26.2±6.38), sex, socioeconomic status, smoking habits selected from relatives of the Kasr Al Aini hospital patients, were also enrolled in our study. Each individual was subjected to detailed occupational and medical history taking and estimation of (A) Environmental air measure of SiO2 : Using X-Ray Fluorescence Analysis at National Research Center , which demonstrates that silica in air is about 10 times exceeding the Egyptian standard for dust fall (B) Some biological analysis included renal urinary biomarkers. High-molecular-weight protein albumin (U.Malb), the low-molecular-weight protein α1-microglobulin (α 1-M), urea and creatinine, urinary creatinine and the lysosomal enzyme N-acetyl-β-D-glucosaminidase (NAG). Results: Our results showed a statistically significant difference between the exposed and the control groups as regards different renal biomarkers as urinary albumin, serum creatinine, urinary creatinine, blood urea, NAG and α 1 microglobulin in urine. We illustrated a statistically significant positive correlation coefficient between duration of exposure