Role of IL-18 in Comparison to Serum Creatinine in Early Detection of Sepsis Induced Acute Kidney Injury in Emergency Department in Suez Canal University Hospital

Abstract

Background:  Septic acute kidney injury is a syndrome of acute impairment of function and organ damage linked with long-term adverse outcomes depending on the extent of acute injury superimposed on underlying organ reserve. Sepsis is the most important cause of Acute Kidney Injury (AKI). Interleukin-18 (IL-18) is a pro-inflammatory cytokine expressed in the renal cortex, peritubular capillaries, and interstitium. Aim: To assess the role of IL-18 in comparison to serum creatinine in the early detection of sepsis-induced acute kidney injury in the Emergency Department (ED) at Suez Canal University Hospital. Subjects and Methods: A comparative cross-sectional study that included two groups of participants. Study group: patient diagnosed with sepsis-induced acute kidney injury attending to the ED at Suez Canal University Hospital. Control group: healthy individuals of the same age group. Patients were clinically assessed and managed by the ABCDE protocol. All patients were subjected to Initial assessment including History, clinical examination, and laboratory investigation, including urinary IL-8. Results: Cases had statistically significant higher urinary IL-18 compared to controls (121.97 ± 75.84 vs 69.07 ± 35.59) (p<0.001). IL-18, a value of 69.5 IU/L was found to be the best cut-off point for the prediction of sepsis-induced AKI among cases, with sensitivity = 6 and 5% specificity = 57.5%. Conclusion: Urinary IL-18 can be used as an early predictor for AKI than serum creatinine in patients presenting with sepsis.