Comparison of Urinary Interleukin-18 as a Biomarker of Acute Kidney Injury With Routine Markers in Intensive Care Units of Tertiary Care Hospitals of Peshawar

Objective This study aims to determine the diagnostic utility of IL-18 for early diagnosis of AKI by comparing it with the routinely used marker serum creatinine. Methods: This validation study was carried out in the Department of Pathology, Khyber Medical College, Peshawar from September 2021 to February’2022. A total of 156 patients with Acute Kidney Injury were recruited from the intensive care units of three Peshawar tertiary care hospitals. Serum and urinary samples were taken at the time of admission and 48 hours after admission to estimate Serum creatinine level and urinary IL-18. Comparisons were made between the diagnostic utility of Urinary IL-18, and serum creatinine using the paired t-test. Sensitivity, specificity, positive predictive value, and negative predictive values were calculated. Results: In this study, 156 acute kidney injury (AKI) patients were included. The mean creatinine level on admission was 0.90 ± 0.26 mg/dl, and after 48 hours of admission, it was 1.38 ± 0.70 mg/dl. Similarly, IL-18 on admission was 130.14 ± 61.31 pg/ml while after 48 hours it was 290.32 ± 136.50 pg/ml. Conclusion: Due to high sensitivity and specificity, Urinary IL-18 can predict AKI 24-48 hours before the onset of renal injury and can be used as an early marker for this purpose.