Assessment of urinary interleukin-18 in the early post-burn period to predict acute kidney injury of various degrees of burn patients

Authors

  • Sharif Qamar Uddin Dhaka University Medical Center and Hospital, Dhaka, Bangladesh
  • M. Nazrul Islam Department of Nephrology, Dhaka Medical College Hospital Dhaka, Bangladesh
  • M. Nizamuddin Chowdhury Department of Nephrology, BRB Hospital Limited, Dhaka, Bangladesh
  • Nizam Uddin Ahmed Chowdhury Department of Nephrology, Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur, Bangladesh
  • Mohammad Zahir Uddin Department of Nephrology, Cumilla Medical College Hospital, Cumilla, Bangladesh
  • Maksuda Begum Mony Department of Nephrology, Universal Medical College, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3933.ijam20220001

Keywords:

Burn patients, Study, Admission, Urinary, AKI, Urinary IL18, Early

Abstract

Background: Early detection of acute kidney injury (AKI) in burn-injured patients can help modify the treatment to prevent progression of acute renal failure and reduce the need for renal replacement therapy. The aim of the study was to evaluate urinary interleukin-18 in the early post-burn period to predict the AKI for the various degrees of burn patients.

Methods: This prospective observational study was conducted in the department of nephrology, Dhaka medical college in collaboration with burn and plastic surgery unit of the same medical college hospital, from July 2017 to June 2018 for a period of one year. The 48 burn patients (Age>18 years) who attended in the burn unit of Dhaka medical college, Dhaka of both sexes were enrolled in this study. Data were analyzed by using SPSS 22.0. A value of p<0.05 was considered statistically significant for all tests.

Results: In this study, mean age of the burn patients was 32.41±10.59 years. Male female ratio was 3.36:1. Urinary IL-18 in diagnosis of AKI showed accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 93.8%, 91.7%, 94.4%, 84.6% and 97.1% respectively. AUC for urinary IL-18 at admission was 0.968 (CI, 0.921-1.000) and AUC for serum creatinine at admission was 0.937 (CI, 0.871-1.000).

Conclusions: According to Kappa value, AUC and sensitivity and specificity urinary IL-18 is a good biomarker in predicting of early AKI in burn patients.

Author Biography

Sharif Qamar Uddin, Dhaka University Medical Center and Hospital, Dhaka, Bangladesh

Senior Medical Officer, Dhaka University Medical Center & Hospital, Dhaka, Bangladesh

References

Bellomo R, Kellum JA, Ronco C. Acute kidney injury. The Lancet. 2012;380(9843):756-66.

Van Biesen W, Vanholder R, Lameire N. Defining acute renal failure: RIFLE and beyond. Clinical journal of the American Society of Nephrology. 2006;1(6):1314-9.

Parikh CR, Abraham E, Ancukiewicz M, Edelstein CL. Urine IL-18 is an early diagnostic marker for acute kidney injury and predicts mortality in the intensive care unit. J Am Society Nephrol. 2005;16(10):3046-52.

Basnakian AG. Netrin-1: a potential universal biomarker for acute kidney injury. Am J Physiology-Renal Physiol. 2008;294(4):F729-30.

Devarajan P. Neutrophil gelatinase-associated lipocalin-an emerging troponin for kidney injury. Nephrology Dialysis Transplantation. 2008;23(12):3737-43.

Lewington AJ, Sayed A. Acute kidney injury: how do we define it? Ann clin biochem. 2010;47(1):4-7.

Adiyanti SS, Loho T. Acute kidney injury (AKI) biomarker. Acta Med Indones. 2012;44(3):246-55.

Vaidya VS, Ferguson MA, Bonventre JV. Biomarkers of acute kidney injury. Annu Rev Pharmacol Toxicol. 2008;48:463-93.

Murray KA. Burn Basics: How to Assess and Treat. Presented at the University of Manitoba’s CME for FPs “Trauma” Update. 2006.

Coca SG, Bauling P, Schifftner T, Howard CS, Teitelbaum I, Parikh CR. Contribution of acute kidney injury toward morbidity and mortality in burns: a contemporary analysis. Am J Kidney Dis. 2007;49(4):517-23.

Melnikov VY, Faubel S, Siegmund B, Lucia MS, Ljubanovic D, Edelstein CL. Neutrophil-independent mechanisms of caspase-1–and IL-18–mediated ischemic acute tubular necrosis in mice. J clin investigation. 2002;110(8):1083-91.

Tschoeke SK, Oberholzer A, Moldawer LL. Interleukin-18: a novel prognostic cytokine in bacteria-induced sepsis. Crit care med. 2006;34(4):1225-33.

Malyszko J. Biomarkers of acute kidney injury in different clinical settings: a time to change the paradigm? Kidney Blood Pressure Res. 2010;33(5):368-82.

Fantuzzi G, Reed DA, Dinarello CA. IL-12-induced IFN-γ is dependent on caspase-1 processing of the IL-18 precursor. The Journal of clinical investigation. 1999;104(6):761-7.

Ren H, Zhou X, Dai D, Liu X, Wang L, Zhou Y et al. Assessment of urinary kidney injury molecule-1 and interleukin-18 in the early post-burn period to predict acute kidney injury for various degrees of burn injury. BMC nephrology. 2015;16(1):1-0.

Murugan R, Kellum JA. Acute kidney injury: what's the prognosis? Nature Rev Nephrol. 2011;7(4):209-17.

Yang HT, Yim H, Cho YS, Kym D, Hur J, Kim JH et al. Assessment of biochemical markers in the early post-burn period for predicting acute kidney injury and mortality in patients with major burn injury: comparison of serum creatinine, serum cystatin-C, plasma and urine neutrophil gelatinase-associated lipocalin. Critical Care. 2014;18(4):1-2.

Palmieri T, Lavrentieva A, Greenhalgh D. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns. Intensive care med. 2009;35(12):2125-9.

Sen ND, Zhou F, Ingolia NT, Hinnebusch AG. Genome-wide analysis of translational efficiency reveals distinct but overlapping functions of yeast DEAD-box RNA helicases Ded1 and eIF4A. Genome res. 2015;25(8):1196-205.

Kuo G, Yang SY, Chuang SS, Fan PC, Chang CH, Hsiao YC et al. Using acute kidney injury severity and scoring systems to predict outcome in patients with burn injury. J Formosan Med Asso. 2016;115(12):1046-52.

Washburn KK, Zappitelli M, Arikan AA, Loftis L, Yalavarthy R, Parikh CR et al. Urinary interleukin-18 is an acute kidney injury biomarker in critically ill children. Nephrol Dialysis Transplantation. 2008;23(2):566-72.

Downloads

Published

2022-01-25

Issue

Section

Original Research Articles