Abstract
BackgroundInterleukin 18 (IL-18) promoter polymorphisms (−656G > T, −607C > A, and −137G > C) affect serum IL- 18 (sIL-18) levels and are associated with renal injury.PurposeThis study aimed to determine the diagnostic utility of sIL-18 and urine IL-18 (uIL-18) as biomarkers for acute kidney injury (AKI) and analyse the association of IL-18 polymorphisms to AKI in preterm infants.MethodsBlood and urine samples were collected from 56 preterm infants with AKI and 56 without AKI to measure serum creatinine (SCr), sIL-18, and uIL-18. Genotyping of polymorphisms was performed and analysed, with AUC-ROCs analysis used to evaluate the diagnostic utility of s-/uIL-18 levels.ResultsThe median sIL-18 and uIL-18 levels were significantly higher than those without AKI. For a cutoff of >132 pg/mL, the sIL-18 expression had sensitivity and specificity of 80.36% and 60.71%, respectively, while for uIL-18, a cutoff of >900.7 pg/mL had sensitivity and specificity of 51.79% and 78.57%, respectively. The odds ratio of sIL-18 and uIL-18 to predict AKI in preterm infants was 5.89 (95%CI:2.31–15.02) and 4.15 (95%CI:1.58–10.89), respectively. The polymorphisms −137G > C and −656G > T were significantly associated with sIL-18 expression.ConclusionSerum and urine IL-18 levels are risk factors for and a moderate predictor of AKI in preterm infants.
Highlights
A ccording to CDC data in 2019, the incidence of preterm birth is 10e15%, with a high rate of morbidity, especially at a gestational age of less than 33e34 weeks due to the immaturity of the organs [1e6]
Purposes This study aims to determine the utility of sIL-18 and urine interleukin 18 as biomarkers of acute kidney injury (AKI) in preterm infants and whether the À137 G > C, À607C > A and À656 G > T polymorphisms are associated with the expression levels of s-/urine IL-18 (uIL-18) and AKI phenotype in preterm infants
The subjects were divided into two groups: the case group (56 infants with AKI) and the control group (56 infants without AKI) and the diagnosis of AKI was according to the neonatal-KDIGO criteria, that is, an increase in serum creatinine of !0.3 mg/dL in the last 48 h or a 150e200% increase in serum creatinine level compared to baseline, and a urine volume of less than 0.5 cc/kg/h
Summary
A ccording to CDC data in 2019, the incidence of preterm birth is 10e15%, with a high rate of morbidity, especially at a gestational age of less than 33e34 weeks due to the immaturity of the organs [1e6]. Several studies have shown that acute kidney injury (AKI) in preterm neonates has shortterm and long-term effects on the kidney [1e9]. The latest diagnostic criteria for AKI as proposed by the Acute Kidney Injury Working Group of KDIGO (Kidney Disease: Improving Global Outcomes) is based in absolute increase of sCr, at least 0.3 mg/dL (26.5 mmol/L) within 48 h or by a 50% increase in sCr from baseline within 7 days, or a urine volume of less than 0.5 mL/kg/h for at least 6 h [12, 13]. Interleukin 18 (IL-18) promoter polymorphisms (¡656G > T, ¡607C > A, and ¡137G > C) affect serum IL18 (sIL-18) levels and are associated with renal injury. Purpose: This study aimed to determine the diagnostic utility of sIL-18 and urine IL-18 (uIL-18) as biomarkers for acute kidney injury (AKI) and analyse the association of IL-18 polymorphisms to AKI in preterm infants
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