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Pediatric Nephrology

, Volume 28, Issue 1, pp 135–144 | Cite as

Impact of sepsis on the urinary level of interleukin-18 and cystatin C in critically ill neonates

  • Yanhong Li
  • Xiaozhong Li
  • Xiaofei Zhou
  • Jie Yan
  • Xueping Zhu
  • Jian Pan
  • Meifang Jin
  • Xueming Zhu
  • Xing FengEmail author
  • Zhihui XiaoEmail author
Original Article

Abstract

Background

Urinary interleukin-18 (uIL-18) and cystatin C (uCysC) are biomarkers of acute kidney injury (AKI). We hypothesized that in non-AKI neonates, the level of uIL-18 and uCysC would be higher in those with sepsis compared to those without sepsis. The aims of this study were to determine the association between urinary biomarkers and sepsis in non-AKI critically ill neonates, and to evaluate whether uIL-18 and uCysC could serve as predictors of sepsis in this population.

Methods

The study included 111 non-AKI critically ill neonates with acute clinical deterioration suggestive of sepsis: 26 with infection, 57 without infection, and 28 were assigned to the unclassified group. Urinary samples were collected and a full sepsis screen was performed at the time of enrollment.

Results

The level of uIL-18, but not uCysC, was significantly elevated in non-AKI septic neonates. Urinary IL-18 was an independent factor associated with sepsis assessed by multivariate analysis, had odds ratio of 1.73 (95 % CI 1.15 to 2.58, p = 0.008), and achieved the area under the receiver operating characteristic curve of 0.74 for predicting the presence of sepsis in non-AKI critically ill neonates.

Conclusions

Sepsis has an impact on the level of uIL-18, but not on the uCysC in non-AKI neonates, suggesting systemic infection might influence the diagnostic value of uIL-18 to detect AKI in the general population.

Keywords

Acute kidney injury Critically ill neonates C-reactive protein Diagnostic test Urinary biomarkers Urinary cystatin C Urinary interleukin-18 Sepsis 

Abbreviations

AKI

Acute kidney injury

AUC

Area under the receiver operating characteristic curve

Cr

Creatinine

CRP

C-reactive protein

CSF

Cerebrospinal fluid

CysC

Cystatin C

IL-18

interleukin-18

NICU

Neonatal intensive care unit

ROC

Receiver operating characteristic

SNAP

The score for neonatal acute physiology

Notes

Acknowledgments

We thank the staff in biochemistry laboratory for technical assistance. This work was supported by grants from the Science and Technology Program of Suzhou (SYS201137).

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Copyright information

© IPNA 2012

Authors and Affiliations

  • Yanhong Li
    • 1
    • 2
  • Xiaozhong Li
    • 2
  • Xiaofei Zhou
    • 3
  • Jie Yan
    • 3
  • Xueping Zhu
    • 3
  • Jian Pan
    • 1
  • Meifang Jin
    • 1
  • Xueming Zhu
    • 1
  • Xing Feng
    • 3
    Email author
  • Zhihui Xiao
    • 3
    Email author
  1. 1.Institute of pediatric researchChildren’s Hospital of Soochow UniversitySuzhouChina
  2. 2.Department of nephrologyChildren’s Hospital of Soochow UniversitySuzhouChina
  3. 3.Department of neonatologyChildren’s Hospital of Soochow UniversitySuzhouChina

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