Is Interleukin-18 an Early Diagnostic Biomarker in Contrast Induced Nephropathy?

Abstract

Introduction: The rise in number of cases of hospital-acquired acute kidney injury in patients undergoing diagnostic and therapeutic procedures by the use of contrast medium is a growing concern among nephrologists. Despite being a delayed marker, the measurement of creatinine level is one of the most popular methods in medical fraternity, to identify the degree of damage caused to the kidneys. Therefore there is a need for development of method for early detection and treatment of the contraindication of contrast media. Since serum Interleukin-18 (IL-18) levels rise early in the disease course, it may be a promising novel biomarker and an early indicator of tubular damage as compared to creatinine and other novel biomarkers. Aim: The current study investigated the early rise in serum IL-18 after contrast induction. Materials and Methods: Randomly selected 30 male wistar rats were given 0.6 mL of contrast iohexol (325 mg of iodine per mL) intraperitoneally and blood samples were collected before and after the induction of contrast by bleeding retro-orbital plexuses under isoflurane (USP) inhalation anaesthesia. Blood samples were collected at 3 hours, 6 hours, 12 hours, 24 hours and 48 hours of post-contrast administration. Results were analysed by using paired Student’s t-test and p-value0.07). Conclusion: The present study reveals an increase in IL-18 levels from 48% to 100% at 6 hours post-contrast induct in comparison to other standard markers like creatinine levels which increases at 48-72 hours post-contrast insult, revealed by the literature. Therefore it can be concluded that IL-18 is a better early novel biomarker for tubular damage assessment, after contrast insult.

Keywords

• acute kidney injury
• cystatin c
• kidney injury molecule-1
• neutrophil gelatinase-associated lipocaline