الفهرس 
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Abstract
Background: major complications of liver cirrhosis include ascites, hepatic encephalopathy, hepatocellular carcinoma, bacterial infections and acute kidney injury (AKI), of which the latter two are common and severe complication in patients with cirrhosis. Neutrophil gelatinase-associated lipocalin (NGAL) is normally expressed at very low levels in several human tissues and body fluids. Ascites NGAL in cirrhotic patients was suggested to serve as a sensitive and specific biomarker for diagnosis of spontaneous bacterial peritonitis (SBP). Also, it was easily detected in urine soon after kidney injury making it an early and non-invasive marker of AKI. Aim: investigate the utility of ascitic NGAL as an early and rapid diagnostic biomarker for the diagnosis of bacterial or bactDNA translocation in ascites of cirrhotic patients and evaluation of urinary NGAL to identify AKI in cirrhotic patients. Setting: Genetic unit at the Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University. Results: There was a high statistically significant elevation of ascites NGAL levels in spontaneous bacterial peritonitis (SBP) group compared to control group. Moreover, values of NGAL in AF were statistically significantly higher in patients with positive bactDNA. As for urine NGAL, patients with AKI had statistically significant higher level of NGAL. Conclusion: early and accurate diagnosis of bacterial or bactDNA translocation can be aided by utilizing NGAL especially in ruling out infection in those reported to have negative culture results, besides, it can help in early detection of AKI helping in improving the prognosis of cirrhotic patients. It is an advantage that a single marker can detect both infection and kidney injury.