Accurate assessment of renal function is of key importance, given its prognostic value. However, gold standard measures are cumbersome, and serum creatinine itself is an insensitive predictor, especially in renal transplant recipients. Though GFR-estimating formulae have been relied upon, they do have their own limitations. Nevertheless, renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C, among others, are now emerging as potentially useful indicators of GFR. We aimed to evaluate the diagnostic performance of NGAL versus cystatin C and eGFR using CKD-EPI, MDRD and cystatin C in renal transplant recipients and non-transplant CKD patients. We found a significant correlation between NGAL, serum creatinine, cystatin C and eGFR. The latter parameters were also strong predictors of serum NGAL levels. However, performance of NGAL, based on receiver operating characteristic curves, was inferior to that of the reference tests. It appears that in renal transplant recipients NGAL correlates well with cystatin C and eGFR, most strongly with cystatin-based formula. Though this suggests potential use of NGAL as a screening test, its weaker diagnostic performance raises some concern about its clinical usefulness. Larger studies are needed to explore this further.

its use will prevent a large number of patients from unnecessary exposure to systemic antibiotics, hence reduce the development of antibiotic resistance and the economic impact of using long term prophylactic systemic antibiotics.Introduction: Background: LMWHs are available since 30 years with wide use in the treatment and prevention of medical and surgical thromboembolic events. The use of LMWHs as anticoagulant in hemodialysis (HD) patients is still not a routine or standard practice. We are using LMWH 'Enoxaparin" since 1998 as a standard anticoagulation in our HD unit, and in a previous publication (1), we found that dose of enoxaparin required in our HD patients, is only the 1/3 of the recommended dose, which was (0.36 mg/kg) Aim of the study: In the current study, we are reporting our 15 year experience of using "Enoxaparin", evaluating following points: the current used dose, the dose according to the type of vascular access, etiology of kidney disease (diabetic, none diabetic), and dialytic mode (HD, HDF) Methods: This study includs 252 HD patients, mean age 56.6 (17) year, Male 145 (57.5 %). Mean duration on HD 50 (44.5) months. 139 (55%) were diabetics, 138 (55%) had AVF, 28 (11%) had AVG, and 86 (34%) had tunneled catheter(TC). 187 (74%) patients were on HD, and 65 (26%) were on line HDF. Results: Total number of HD sessions during the 15 years use of " Enoxaparin" was 350,000. The average dose of " Enoxaparin" was 0.31 (0.14) mg/kg/session. 0.29 (0.13), 0.34 (0.17), and 0.34 (0.14) mg/kg/ session, were the average doses used in AVF, AVG, and TC respectively with p¼0.03. The dose used in DM patients was 0.30 (0.13), and 0.34 (0.13) mg/kg in non DM, withp¼0.15. Average dose in HD was o.31 (0.13), and in HDF 0.32 (0.15) mg/kg, p¼0.69 Conclusions: To the best of our knowledge this study is the longest, and the largest experience ever reported with the use of LMWH " Enoxaparin" as a standard anticoagulant in HD. The average dose used continued to be low and stable with time. Only the type of vascular access impact significantly the required dose.

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