Integrated biomarkers and renal Doppler for early acute kidney injury diagnosis in hepatitis C virus cirrhosis

doi:10.5527/wjn.119581

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Sep 25, 2026; 15(3): 119581
Published online Sep 25, 2026. doi: 10.5527/wjn.119581

Integrated biomarkers and renal Doppler for early acute kidney injury diagnosis in hepatitis C virus cirrhosis

Fatma M Attia Elsayed, Mona Mahmoud Eladl, Magy Magdy Mohamed, Amira A A Othman

Amira A A Othman, Department of Internal Medicine, Faculty of Medicine, Suez University, Suez 43511, Egypt

Magy Magdy Mohamed, Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt

Mona Mahmoud Eladl, Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt

Fatma M Attia Elsayed, Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt

Author contributions: Othman AAA, Mohamed MM, Eladl MM, and Elsayed FMA were responsible for concept and design of the study, data acquisition, statistical analysis, interpretation of the results, analysis of the data, drafting of the manuscript, critically revising the manuscript, approval of the final version to be published, and agreement to be accountable for all aspects of the work.

AI contribution statement: Grammarly Premium was used solely for language editing, including correction of grammar, spelling, and clarity of expression. No generative AI tools such as ChatGPT or others were used.

Institutional review board statement: Ethical approval was obtained from the Institutional Review Board of Suez University (No. 9-SU-Med-2023). The approved study protocol identified Zagazig University Hospitals as the recruitment and data collection site.

Clinical trial registration statement: The study protocol was prospectively registered at the Pan African Clinical Trials Registry (PACTR202505555006910; registration date: April 18, 2025).

Informed consent statement: All participants provided informed consent.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: All summarized findings are included in this published article. The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Corresponding author: Amira A A Othman, MD, PhD, Lecturer, Principal Investigator, Department of Internal Medicine, Faculty of Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg

Received: February 2, 2026
Revised: February 7, 2026
Accepted: March 24, 2026
Published online: September 25, 2026
Processing time: 194 Days and 20.3 Hours

Core Tip

Core Tip: Acute kidney injury (AKI) in cirrhosis is frequently underdiagnosed in resource-limited settings due to the unreliability of serum creatinine. This prospective Egyptian study, conducted in the hepatitis C virus-endemic population, demonstrates that integrating serum neutrophil gelatinase-associated lipocalin, cystatin C, and renal resistive index enables earlier AKI detection, accurate subtyping (pre-renal, hepatorenal syndrome, acute tubular necrosis), and improved short-term prognostication. We provide the first region-specific evidence that a simple neutrophil gelatinase-associated lipocalin-renal resistive index-based algorithm, supported by point-of-care ultrasound, can guide clinical triage and reduce unnecessary intensive care unit utilization in real-world Egyptian practice. These findings offer a practical, scalable diagnostic framework for cirrhosis-associated AKI in low-income and middle-income countries.