الفهرس 
Acute renal failureOnly 14 pages are availabe for public view
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Abstract
Fifty patients (50) had been randomly recuited from those admitted in
ICU of Benha University Hospitals.
Criteria of patients selected: each patient entered ICU except those
with exclusion criteria on admission.
Exclusion criteria:
1- Anuria.
2- Renal replacement therapy.
3- Resolving ARF.
4- Absence of an indwelling urethral catheter.
5- Contamination of urine with radioactivity or cytotoxics.
The patients were classified into two groups, depending on the
presence or absence of ARF at any time during their ICU stay:
group I (control group) composed of 41 patients (82%) ( 60% males –
40% females) and group 2 (acute renal failure group) composed of 9
patients (18%) ( 44.5% males – 55.5% females).
ARF was defined as an increase in serum creatinine concentration
of 0.5 mg/dl or more over the baseline or a reduction in the calculated
creatinine clearance of 50% according to (Anderson and Barry, 2004).
To all patients who participated in this study the following had
been done:
1- Thorough history taking.
2- Complete clinical examination.
3- Investigations: For all patients admitted to the study, blood and
urine samples had been collected daily and serum creatinine,
creatinine clearance, fractional execration of sodium and some
urinary enzymes were measured for seven days.
Summary and Conclusion and Recommendation
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This study showed the following results:
1- Alkaline phosphatase shown a statistically significant increase in
urinary excretion and was useful in early detection of acute renal
impairment during the first week of admission to the ICU.
2- γ glutamyl transpeptidase shown a statistically significant
increase in urinary excretion and was useful in early detection of
acute renal impairment during the first week of admission to the
ICU.
Conclusion
Tubular enzymuria on admission to the ICU is useful in predicting
ARF. The cheapiness and availability of automated assays for γGT and
AP suggests that estimation of these enzymes in random urine samples
may be useful for identifying patients at high risk of ARF.
Recommendations
Further studies well be conducted to compare
1- The incidence of ARF in intensive care unit patients and the effect
of different predisposing factors.
2- The sensitivity and specificity of urinary enzymes; alkaline
phosphatase and gamma glutamyl transpeptidase in early detection
of acute renal impairment.