Serum Neutrophil Gelatinase Associated Lipocaline to Detect Acute Kidney Injury in Acute Variceal Bleeding in Liver Cirrhotic Patients

Abstract

Cirrhosis is a chronic (ongoing, long-term) disease of the liver. It means damage to the normal liver tissue that prevents this important organ from working as it should. If the damage is not stopped, the liver gradually loses its ability to carry out its normal functions. This is called liver failure, sometimes referred to as end-stage liver disease. Cirrhosis of the liver is disease found all over the world, affecting all races, age groups and both sexes. The clinical presentation of liver cirrhosis is often asymptomatic until complications appear. Most chronic liver disease is notoriously asymptomatic until cirrhosis with clinical decompensation occurs. Decompensating events include ascites, sepsis, variceal bleeding, encephalopathy, and non-obstructive jaundice. Acute kidney injury (AKI) is common in patients with cirrhosis and associated with significant mortality. The most common etiologies of AKI in this setting are prerenal azotemia (PRA), acute tubular necrosis (ATN), and hepatorenal syndrome (HRS). Accurately distinguishing the etiology of AKI is critical, as treatments differ markedly. However, establishing an accurate differential diagnosis is extremely challenging.