Document Detail


Urinary IL-18 is an early predictive biomarker of acute kidney injury after cardiac surgery.
MedLine Citation:
PMID:  16710348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute kidney injury (AKI) is a frequent complication of cardiopulmonary bypass (CPB). The lack of early biomarkers for AKI has impaired our ability to intervene in a timely manner. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is recently demonstrated as an early biomarker of AKI after CPB, increasing 25-fold within 2 h and declining 6 h after surgery. In the present study, we tested whether interleukin-18 (IL-18) is a predictive biomarker for AKI in the same group of patients following CPB. Exclusion criteria included pre-existing renal insufficiency and nephrotoxin use. Serial urine samples were analyzed by enzyme-linked immunosorbent assay for IL-18 in 20 patients who developed AKI (defined as a 50% or greater increase in serum creatinine after CPB) and 35 controls (age, race, and gender-matched patients who did not develop AKI after CPB). Using serum creatinine, AKI was detected only 48-72 h after CPB. In contrast, urine IL-18 increased at 4-6 h after CPB, peaked at over 25-fold at 12 h, and remained markedly elevated up to 48 h after CPB. The performance of IL-18 as demonstrated by area under the receiver operating characteristics curve for diagnosis of AKI at 4, 12, and 24 h after CPB was 61, 75, and 73% respectively. Also, on multivariate analysis, both IL-18 and NGAL were independently associated with number of days in AKI among cases. Our results indicate that IL-18 is an early, predictive biomarker of AKI after CPB, and that NGAL and IL-18 are increased in tandem after CPB. The combination of these two biomarkers may allow for the reliable early diagnosis and prognosis of AKI at all times after CPB, much before the rise in serum creatinine.
Authors:
C R Parikh; J Mishra; H Thiessen-Philbrook; B Dursun; Q Ma; C Kelly; C Dent; P Devarajan; C L Edelstein
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-05-17
Journal Detail:
Title:  Kidney international     Volume:  70     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-30     Completed Date:  2006-08-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  199-203     Citation Subset:  IM    
Affiliation:
Section of Nephrology, Yale University, New Haven, Connecticut 06516, USA. chirag.parikh@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Acute-Phase Proteins / urine
Biological Markers / urine
Cardiopulmonary Bypass / adverse effects*
Child
Creatinine / blood
Early Diagnosis
Female
Humans
Interleukin-18 / urine*
Kidney Failure, Acute / diagnosis*
Lipocalins
Male
Prognosis
Proto-Oncogene Proteins / urine
Thoracic Surgery
Grant Support
ID/Acronym/Agency:
K23-DK064689/DK/NIDDK NIH HHS; P01-DK34039/DK/NIDDK NIH HHS; P50-DK52612/DK/NIDDK NIH HHS; R01-DK53289/DK/NIDDK NIH HHS; R01-DK56851/DK/NIDDK NIH HHS; R21-DK070163/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Acute-Phase Proteins; 0/Biological Markers; 0/Interleukin-18; 0/LCN2 protein, human; 0/Lipocalins; 0/Proto-Oncogene Proteins; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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