PMID- 25472925 OWN - NLM STAT- MEDLINE DCOM- 20150428 LR - 20220317 IS - 1471-6771 (Electronic) IS - 0007-0912 (Linking) VI - 114 IP - 3 DP - 2015 Mar TI - Predictive value of urine interleukin-18 in the evolution and outcome of acute kidney injury in critically ill adult patients. PG - 460-8 LID - 10.1093/bja/aeu382 [doi] AB - BACKGROUND: Interleukin-18 (IL-18) is a pro-inflammatory protein, which mediates ischaemic tubular injury, and has been suggested to be a sensitive and specific biomarker for acute kidney injury (AKI). The predictive value of IL-18 in the diagnosis, evolution, and outcome of AKI in critically ill patients is still unclear. METHODS: We measured urine IL-18 from critically ill patients at intensive care unit (ICU) admission and 24 h. We evaluated the association of IL-18 with developing new AKI, renal replacement therapy (RRT), and 90-day mortality. We calculated areas under receiver operating characteristics curves (AUCs), best cut-off values, and positive likelihood ratios (LR+) for IL-18 concerning these endpoints. Additionally, we compared the predictive value of IL-18 at ICU admission to that of urine neutrophil gelatinase-associated lipocalin (NGAL). RESULTS: In this study population of 1439 patients the highest urine IL-18 during the first 24 h in the ICU associated with the development of AKI with an AUC [95% confidence interval (CI)] of 0.586 (0.546-0.627) and with the development of Stage 3 AKI with an AUC (95% CI) of 0.667 (0.591-0.774). IL-18 predicted the initiation of RRT with an AUC (95% CI) of 0.655 (0.572-0.739), and 90-day mortality with an AUC (95% CI) of 0.536 (0.497-0.574). CONCLUSIONS: IL-18 had poor-to-moderate ability to predict AKI, RRT, or 90-day mortality in this large cohort of critically ill patients. Thus, it should be used with caution for diagnostic or predictive purposes in the critically ill. CI - (c) The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com. FAU - Nisula, S AU - Nisula S AD - Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Department of Surgery and sara.nisula@hus.fi. FAU - Yang, R AU - Yang R AD - Critical Care Medicine Research Group, Department of Intensive Care Medicine, Tampere University Hospital, Tampere, Finland. FAU - Poukkanen, M AU - Poukkanen M AD - Department of Anaesthesia and Intensive Care Medicine, Lapland Central Hospital, Rovaniemi, Finland. FAU - Vaara, S T AU - Vaara ST AD - Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Department of Surgery and. FAU - Kaukonen, K M AU - Kaukonen KM AD - Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Department of Surgery and. FAU - Tallgren, M AU - Tallgren M AD - Department of Anesthesia and Intensive Care Medicine, Turku University Hospital, Turku, Finland. FAU - Haapio, M AU - Haapio M AD - Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Box 340, Helsinki 00029, Finland. FAU - Tenhunen, J AU - Tenhunen J AD - Department of Surgical Sciences/Anaesthesiology and Intensive Care, University of Uppsala, Uppsala, Sweden. FAU - Korhonen, A M AU - Korhonen AM AD - Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Department of Surgery and. FAU - Pettila, V AU - Pettila V AD - Intensive Care Units, Division of Anaesthesia and Intensive Care Medicine, Department of Surgery and. CN - FINNAKI Study Group LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20141203 PL - England TA - Br J Anaesth JT - British journal of anaesthesia JID - 0372541 RN - 0 (Biomarkers) RN - 0 (Interleukin-18) SB - IM MH - Acute Kidney Injury/mortality/therapy/*urine MH - Aged MH - Area Under Curve MH - Biomarkers/urine MH - Critical Illness MH - Female MH - Follow-Up Studies MH - Humans MH - Intensive Care Units MH - Interleukin-18/*urine MH - Male MH - Middle Aged MH - *Patient Outcome Assessment MH - Predictive Value of Tests MH - Prospective Studies MH - ROC Curve MH - Renal Replacement Therapy/statistics & numerical data OTO - NOTNLM OT - acute kidney injury OT - critical illness OT - intensive care OT - interleukin-18 OT - long-term outcome OT - renal replacement therapy FIR - Laru-Sompa, Raili IR - Laru-Sompa R FIR - Pulkkinen, Anni IR - Pulkkinen A FIR - Saarelainen, Minna IR - Saarelainen M FIR - Reilama, Mikko IR - Reilama M FIR - Tolmunen, Sinikka IR - Tolmunen S FIR - Rantalainen, Ulla IR - Rantalainen U FIR - Miettinen, Marja IR - Miettinen M FIR - Suvela, Markku IR - Suvela M FIR - Pesola, Katrine IR - Pesola K FIR - Saastamoinen, Pekka IR - Saastamoinen P FIR - Kauppinen, Sirpa IR - Kauppinen S FIR - Pettila, Ville IR - Pettila V FIR - Kaukonen, Kirsi-Maija IR - Kaukonen KM FIR - Korhonen, Anna-Maija IR - Korhonen AM FIR - Nisula, Sara IR - Nisula S FIR - Vaara, Suvi IR - Vaara S FIR - Suojaranta-Ylinen, Raili IR - Suojaranta-Ylinen R FIR - Mildh, Leena IR - Mildh L FIR - Haapio, Mikko IR - Haapio M FIR - Nurminen, Laura IR - Nurminen L FIR - Sutinen, Sari IR - Sutinen S FIR - Pettila, Leena IR - Pettila L FIR - Laitinen, Helina IR - Laitinen H FIR - Syrja, Heidi IR - Syrja H FIR - Henttonen, Kirsi IR - Henttonen K FIR - Lappi, Elina IR - Lappi E FIR - Boman, Hillevi IR - Boman H FIR - Varpula, Tero IR - Varpula T FIR - Porkka, Paivi IR - Porkka P FIR - Mira Rahkonen, Mirka Sivula IR - Mira Rahkonen MS FIR - Tsurkka, Anne IR - Tsurkka A FIR - Nieminen, Taina IR - Nieminen T FIR - Prittinen, Niina IR - Prittinen N FIR - Alaspaa, Ari IR - Alaspaa A FIR - Salanto, Ville IR - Salanto V FIR - Juntunen, Hanna IR - Juntunen H FIR - Sanisalo, Teija IR - Sanisalo T FIR - Parviainen, Ilkka IR - Parviainen I FIR - Uusaro, Ari IR - Uusaro A FIR - Ruokonen, Esko IR - Ruokonen E FIR - Bendel, Stepani IR - Bendel S FIR - Rissanen, Niina IR - Rissanen N FIR - Lang, Maarit IR - Lang M FIR - Rahikainen, Sari IR - Rahikainen S FIR - Rissanen, Saija IR - Rissanen S FIR - Ahonen, Merja IR - Ahonen M FIR - Halonen, Elina IR - Halonen E FIR - Vaskelainen, Eija IR - Vaskelainen E FIR - Poukkanen, Meri IR - Poukkanen M FIR - Lintula, Esa IR - Lintula E FIR - Suominen, Sirpa IR - Suominen S FIR - Heikkinen, Jorma IR - Heikkinen J FIR - Lavander, Timo IR - Lavander T FIR - Heinonen, Kirsi IR - Heinonen K FIR - Juopperi, Anne-Mari IR - Juopperi AM FIR - Kaminski, Tadeusz IR - Kaminski T FIR - Gaddnas, Fiia IR - Gaddnas F FIR - Kuusela, Tuija IR - Kuusela T FIR - Roiko, Jane IR - Roiko J FIR - Karlsson, Sari IR - Karlsson S FIR - Reinikainen, Matti IR - Reinikainen M FIR - Surakka, Tero IR - Surakka T FIR - Jyrkonen, Helena IR - Jyrkonen H FIR - Eiserbeck, Tanja IR - Eiserbeck T FIR - Kallinen, Jaana IR - Kallinen J FIR - Lund, Vesa IR - Lund V FIR - Tuominen, Paivi IR - Tuominen P FIR - Perkola, Pauliina IR - Perkola P FIR - Tuominen, Riikka IR - Tuominen R FIR - Hietaranta, Marika IR - Hietaranta M FIR - Johansson, Satu IR - Johansson S FIR - Hovilehto, Seppo IR - Hovilehto S FIR - Kirsi, Anne IR - Kirsi A FIR - Tiainen, Pekka IR - Tiainen P FIR - Myllarinen, Tuija IR - Myllarinen T FIR - Leino, Pirjo IR - Leino P FIR - Toropainen, Anne IR - Toropainen A FIR - Kuitunen, Anne IR - Kuitunen A FIR - Leppanen, Ilona IR - Leppanen I FIR - Levoranta, Markus IR - Levoranta M FIR - Hoppu, Sanna IR - Hoppu S FIR - Sauranen, Jukka IR - Sauranen J FIR - Tenhunen, Jyrki IR - Tenhunen J FIR - Kukkurainen, Atte IR - Kukkurainen A FIR - Kortelainen, Samuli IR - Kortelainen S FIR - Varila, Simo IR - Varila S FIR - Inkinen, Outi IR - Inkinen O FIR - Koivuviita, Niina IR - Koivuviita N FIR - Kotamaki, Jutta IR - Kotamaki J FIR - Laine, Anu IR - Laine A FIR - Ala-Kokko, Tero IR - Ala-Kokko T FIR - Laurila, Jouko IR - Laurila J FIR - Salkio, Sinikka IR - Salkio S FIR - Koivisto, Simo-Pekka IR - Koivisto SP FIR - Hautamaki, Raku IR - Hautamaki R FIR - Skinnar, Maria IR - Skinnar M EDAT- 2014/12/05 06:00 MHDA- 2015/04/29 06:00 CRDT- 2014/12/05 06:00 PHST- 2014/12/05 06:00 [entrez] PHST- 2014/12/05 06:00 [pubmed] PHST- 2015/04/29 06:00 [medline] AID - S0007-0912(17)31812-3 [pii] AID - 10.1093/bja/aeu382 [doi] PST - ppublish SO - Br J Anaesth. 2015 Mar;114(3):460-8. doi: 10.1093/bja/aeu382. Epub 2014 Dec 3.