Urine interleukin-18 and cystatin-C as biomarkers of acute kidney injury in critically ill neonates.
BACKGROUND
Urinary interleukin-18 and cystatin-C are suggested to be biomarkers for predicting acute kidney injury (AKI). The aims of this study are to examine whether the urinary concentrations of interleukin-18 and cystatin-C vary with gestational age and other factors in non-AKI control neonates, and to determine whether urinary interleukin-18 and cystatin-C can predict AKI development in non-septic critically ill neonates, independently of potential confounders.


METHODS
We enrolled 62 non-septic critically ill neonates. Urine was collected every 48-72 h during the first 10 days of life.


RESULTS
Urinary concentration of cystatin-C, but not interleukin-18, decreased with increasing gestational age and body weight, but not with increasing postnatal age in non-AKI control neonates. Both urinary interleukin-18 and cystatin-C were associated with AKI, even after controlling for gestational and postnatal age, birth weight, gender, Apgar score and the score for neonatal acute physiology in non-septic critically ill neonates. Urinary interleukin-18 and cystatin-C had odds ratios of 2.27 and 2.07, and achieved the area under-the-receiver-operating-characteristic curve of 0.72 and 0.92, respectively, for predicting AKI.


CONCLUSIONS
The urinary concentration of cystatin-C, but not interleukin-18, may decrease with increasing renal maturity. Both urinary interleukin-18 and cystatin-C are independently predictive of AKI in non-septic critically ill neonates.
Department of Nephrology, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China. lyh072006@hotmail.com
Yanhong
Y
Li
Chenlu
C
Fu
Xiaofei
X
Zhou
Zhihui
Z
Xiao
Xueming
X
Zhu
Meifang
M
Jin
Xiaozhong
X
Li
Xing
X
Feng
D058186:Acute Kidney Injury / Q000652:urine*; D000375:Aging / Q000378:metabolism; D001034:Apgar Score; D015415:Biomarkers / Q000652:urine; D001724:Birth Weight / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D016638:Critical Illness; D055316:Cystatin C / Q000652:urine*; D003625:Data Collection; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005865:Gestational Age; D006801:Humans; D007120:Immunochemistry; D007231:Infant, Newborn; D020382:Interleukin-18 / Q000652:urine*; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012727:Sex Characteristics
D015415:Biomarkers; D055316:Cystatin C; D020382:Interleukin-18