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Background: Acute kidney injury (AKI) is routinely diagnosed by creatinine-based guidelines, which is sub-optimal marker after injury due to renal and non-renal factors. This has necessitated the need for more specific and sensitive biomarkers for early detection of AKI in at risk patients. This prospective cross-sectional study used the biomarkers of cell cycle arrest and Neutrophil Gelatinase Associated Lipocalin (NGAL) to assess AKI among hospitalized patients. Methods: We conveniently enrolled 151 in-patients at the Trauma and Specialist Hospital, Winneba in Ghana. Socio-demographic and clinical information were collected using structured questionnaires. Blood samples were collected for the estimation of serum creatinine, and AKI diagnosed and staged using the KDIGO guideline. Fresh urine samples were collected and urinary NGAL, TIMP-2 (tissue inhibitor metalloproteinase 2) and IGFBP-7 (insulin-like growth factor binding protein 7) were estimated using ELISA kits. Results: The cell cycle arrest biomarkers and NGAL were significantly (P < 0.001) higher among participants with AKI than those without AKI. [TIMP-2]∗[IGFBP-7] showed the best diagnostic performance (AUC = 0.94, CI = 0.90–0.98) followed by [IGFBP-7]∗NGAL] (AUC = 0.93, CI = 0.87–0.99), with NGAL having the least (AUC = 0.62, CI = 0.46–0.78). The cut-off for [TIMP-2]∗[IGFBP-7] showed the best predictive ability (95.8% sensitivity, 77.2% specificity, 44.2% PPV and 99% NPV). The cut-off for NGAL, on the other hand, showed the least predictive ability (62.5% sensitivity, 42.5% specificity, 17.0% PPV and 85.7% NPV). Conclusion: Tissue inhibitor metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) best predicts the development of AKI, and can be used in high risk patients for early diagnosis of AKI.

Background: Acute and chronic exposure to wood smoke is associated with adverse health effects. This study investigated the potential effect of persistent exposure to woodsmoke on hematological and biochemical indices among regular wood burners in the Cape Coast Metropolis, Ghana. Methodology: A total of 101 consenting participants were recruited into the study. Serum lipids (total cholesterol, high density lipoprotein, triglyceride, low density lipoprotein, very low-density lipoprotein and non-HDL), renal function (urea, creatinine), liver enzymes (AST and ALT) were measured using an automated analyzer. The full blood count of participants was also measured with an FBC automated analyzer. Demographic and lifestyle data of the participants were obtained with the help of questionnaires. Results: Individuals exposed to wood smoke were older (47.21±1.583), smoked fish [36(47.4%)] and were predominantly females. Female preponderance [75(98.7%), P = 0.046], low haemoglobin (HGB) [OR= 6.553 (95%CI=1.431 to 30.01), P = 0.0094], low MCV [OR=12.43(95%CI=0.7133 to 216.5), P = 0.018], low MCH [OR=4.145(95%CI=1.284 to 13.38), P = 0.0151], low MCHC [OR=9.844(95%CI=3.029 to 31.99), P