Interleukin-18 and vascular endothelial growth factor as predictors for end-stage renal disease

Abstract

Objective The objective of this study was to evaluate the role of interleukin-18 (IL-18) and vascular endothelial growth factor (VEGF) in end-stage renal disease (ESRD), and the influence of comorbidities like diabetes and viral hepatitis on their levels. Background IL-18 and VEGF are inflammatory cytokines playing important roles in the pathogenesis of ESRD and related comorbidities like diabetic nephropathy and viral hepatitis. Patients and methods This study was conducted on 96 patients undergoing hemodialysis (25 diabetic patients with hepatic viral infections, 25 diabetic patients without hepatic viral infections, 25 nondiabetic patients with hepatic viral infections, and 21 age-matched and sex-matched healthy individuals as a control group). All patients were subjected to full history taking, clinical examination, and laboratory investigations. Serum IL-18 and VEGF levels were measured for all the study individuals by using enzyme-linked immunosorbent assay technique. Results The prevalence of IL-18 and VEGF was higher in diabetic patients and patients with hepatitis comparing with the controls (P = 0.001). A detectable level of IL-18 was found in 100% of diabetic patients with and without viral hepatitis, and in 44% of the ones with only hepatitis (P = 0.001). A detectable level of VEFG was found in 100% of the patients with only diabetes and only hepatitis, and in 80% of the ones with combined diabetes and hepatitis (P = 0.001). Conclusion There is high elevation of both IL-18 and VEGF serum levels in ESRD associated with diabetic nephropathy and viral hepatitis. Serum IL-18 is higher in diabetic than hepatic nephropathy, whereas the opposite is seen with VEGF.