Predictive value of urine interleukin-18 in the evolution and outcome of acute kidney injury in critically ill adult patients

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Nisula, S. (author)

Predictive value of urine interleukin-18 in the evolution and outcome of acute kidney injury in critically ill adult patients

Article/chapterEnglish2015

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Elsevier BV,2015
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LIBRIS-ID:oai:DiVA.org:uu-251448
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-251448URI
https://doi.org/10.1093/bja/aeu382DOI

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Language:English
Summary in:English

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Background. Interleukin-18 (IL-18) is a pro-inflammatory protein, which mediates ischaemic tubular injury, and has been suggested to be a sensitive and specific biomarker for acute kidney injury (AKI). The predictive value of IL-18 in the diagnosis, evolution, and outcome of AKI in critically ill patients is still unclear. Methods. We measured urine IL-18 from critically ill patients at intensive care unit (ICU) admission and 24 h. We evaluated the association of IL-18 with developing new AKI, renal replacement therapy (RRT), and 90-day mortality. We calculated areas under receiver operating characteristics curves (AUCs), best cut-off values, and positive likelihood ratios (LR+) for IL-18 concerning these endpoints. Additionally, we compared the predictive value of IL-18 at ICU admission to that of urine neutrophil gelatinase-associated lipocalin (NGAL). Results. In this study population of 1439 patients the highest urine IL-18 during the first 24 h in the ICU associated with the development of AKI with an AUC [95% confidence interval (CI)] of 0.586 (0.546-0.627) and with the development of Stage 3 AKI with an AUC (95% CI) of 0.667 (0.591-0.774). IL-18 predicted the initiation of RRT with an AUC (95% CI) of 0.655 (0.572-0.739), and 90-day mortality with an AUC (95% CI) of 0.536 (0.497-0.574). Conclusions. IL-18 had poor-to-moderate ability to predict AKI, RRT, or 90-day mortality in this large cohort of critically ill patients. Thus, it should be used with caution for diagnostic or predictive purposes in the critically ill.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
acute kidney injury
critical illness
interleukin-18
intensive care
long-term outcome
renal replacement therapy

Added entries (persons, corporate bodies, meetings, titles ...)

Yang, R. (author)
Poukkanen, M. (author)
Vaara, S. T. (author)
Kaukonen, K. M. (author)
Tallgren, M. (author)
Haapio, M. (author)
Tenhunen, JyrkiUppsala universitet,Anestesiologi och intensivvård(Swepub:uu)jyrte348 (author)
Korhonen, A. M. (author)
Pettila, V. (author)
Uppsala universitetAnestesiologi och intensivvård (creator_code:org_t)

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In:British Journal of Anaesthesia: Elsevier BV114:3, s. 460-4680007-09121471-6771

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By the author/editor: Nisula, S.; Yang, R.; Poukkanen, M.; Vaara, S. T.; Kaukonen, K. M.; Tallgren, M.; show more...; Haapio, M.; Tenhunen, Jyrki; Korhonen, A. M.; Pettila, V.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Urology and Neph ...

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