Urinary IL-18 as an early marker for acute kidney injury in snake bite

Abstract

Background: Several biomarkers have been thrown into limelight to be an early predictor of Acute Kidney Injury (AKI). Aim and Objectives:To establish the relation between Urinary IL-18 (UIL-18) and AKI and the reliability for use as early markers in the detection of AKI compared to pre-existing surrogate markers for kidney injury such as creatinine and urea. Material and Methods: This is a cross-sectional study which was conducted at Gandhi Hospital, Hyderabad. Study was conducted for duration between 2018-2020 among the patients presenting with the history of snake bite. Total 80 patients with history of snake bite were included in present study after obtaining the informed consent from them all. The patients were followed up and the data were collected in proforma. Results: Mean age of the patients in present study was 39.32 ± 8.95 years of age, with male preponderance. Majority of the patients came with history of viper bite (45%) followed with unknown snake bite (30%), and (12.5%) each with cobra and krait bite. At 12 hr of admission, IL-18 showed a significant higher mean among AKI patients compared to urea and creatinine which were within the normal range. At 48 hr, all the three variables were significantly higher in AKI patients compared to patients without AKI. The cut-off of the 35.31 pg/ml of the UIL-18 was assessed to predict the AKI at 12 hr of follow-up with sensitivity of 48% and specificity of 93.3%. Conclusion:IL-18 helps to predict the occurrence of the AKI among the patients with snake bite when the urea and serum creatinine levels are well within the normal range at the 12 hr of the admission. There is a strong strength of association between the blood urea and serum creatinine with the UIL-18.

Keywords

• acute kidney injury
• creatinine
• interleukin (il)-18
• snake bite
• urea