Urinary interleukin-18 is an acute kidney injury biomarker in critically ill children

Abstract

Urinary IL-18 rises prior to SCr in non-septic critically ill children, predicts severity of AKI and is an independent predictor of mortality.

Urinary Interleukin (Il)-18 as an Early Predictive Biomarker of Subclinical Proximal Tubular Dysfunction in HIV-Infected Patients Exposed to Tenofovir

“…From this study it was found that IL-18 seems to be a very reliable and accurate marker of subclinical nephropathy, especially tubulopathy in HIV-infected patients on TDF. This finding agrees with other workers that IL-18 might be used as a marker to identify patients with proximal tubular dysfunction [11,12]. Finally, the present findings further suggest that longer periods of observation may increase the number of patients with subclinical signs of nephropathy in patients exposed to TDF regimen since proximal tubular dysfunction in these patients is progressive.…”

“…The difference between the groups was highly statistically significant at different time point studied. Perhaps, this finding is expected since IL-18 increases in urine only under condition of a marked tubular damage, apoptotic tubular cell shedding, and cell necrosis, associated with deterioration of renal function [11]. From this study it was found that IL-18 seems to be a very reliable and accurate marker of subclinical nephropathy, especially tubulopathy in HIV-infected patients on TDF.…”

“…The results of the present study suggest that an increase in the urinary concentration of IL-18 followed the expression of classic laboratory features of renal insufficiency. IL-18 has also been reported to be a strong prognostic indicator of mortality in children treated in intensive care units [11]. Furthermore, Edelstein et al [1] pointed out that IL-18 can also be a very useful predictive marker of renal insufficiency.…”

“…Many investigators have analyzed urinary concentrations of IL-18 as an early markers of proximal renal injury. Their results suggest that IL-18 might be used as a marker to identify patients with proximal tubular dysfunction [11,12]. There are no reports on, studies to assess IL-18 value as a marker of proximal tubular disorder after months of exposure to TDF and other antiretroviral therapeutic agents in HIV-infected patients.…”

Incorporation of Biomarkers with the Renal Angina Index for Prediction of Severe AKI in Critically Ill Children

“…However, in noncardiac PICU patients, performance of these same biomarkers is variable, with area under the curve receiver-operating characteristic (AUC-ROC) values ranging from 0.54 to 0.85 (Table 1) (4-7). Our previous data indicate that children suffering AKI.48 hours after admission are at highest risk for poor clinical outcome, including prolonged length of stay, need for RRT, or mortality (5,8). Thus, identification of patients at risk of AKI early in their intensive care unit (ICU) admission may help clinicians optimize the timing of resuscitative and supportive therapies.…”