Comparative study of Urinary neutrophil gelatinase-associated lipocalin and Interlukin-18 versus serum creatinine in early detection of acute kidney injury in critically ill patients

Abstract

Abstract

In this study, we examine uNGAL and uIL-18 as predictors of AKI in comparison to serum creatinine in 30 patients admitted to ICU. We compared the patients who developed AKI using AKIN criteria to those who did not. Then we evaluated those who were diagnosed with AKI using the creatinine criteria of AKIN only. Finally, we studied those patients who were diagnosed at the day of admission with AKI mainly using the urine output criteria of AKI. Our results should that uNGAL and uIL-18 are poorly predictive for the development of AKI early in the ICU stay. The AUC-ROC for both biomarkers ranged between 0.5 and 0.63 in the days of the study. When using creatinine alone to diagnose AKI the results improved to be 0.5-0.7. The only significant result was uIL-18 measured at day of admission. It was found to be elevated in patients who developed AKI at the day of ICU admission with AUC-ROC 0.805 (95% CI: 0.514 – 1.0). Our study and other previous studies have different results in the relevance of both uNGAL and uIL-18 in diagnosis of AKI. Those studies were different regarding the methodology and the defining criteria of AKI. This role cannot be clearly identified by comparing them to serum creatinine. Serum creatinine is a functional biomarker while both uNGAL and uIL-18 are injury makers.