Clinical research of urine neutrophil gelatinase-associated lipocalin and interleukin-18 on critically ill patients with acute kidney injury receiving continuous veno-venous hemofiltration

Objective To explore the effect of urine neutrophil gelatinase-associated lipocalin(uNGAL) and urine interleukin-18(uIL-18) on the ill condition and prognosis in critically ill patients with acute kidney injury(AKI)at inception of continuous veno-venous hemofiltration(CVVH). Methods Children came from Department of Nephrology, PICU and health examination center in Guangzhou Women and Children's Medical Center were divided into 4 groups: critically ill patients with AKI receiving CVVH group(group A), critically ill patients with non-AKI recei-ving CVVH group(group B), critically ill patients with AKI didn't recevie CVVH group(group C), and healthy control group(group D). Serum creatinine(SCr), uNGAL and uIL-18 in all patients were analyzed. Results The uNGAL in group A and group C[(161.56±71.44) μg/L, (153.69±51.33) μg/L] increased obviously when compared with group B and group D[(33.50±10.76) μg/L, (16.37±6.20) μg/L](all P 0.05). The peak level of uNGAL[(241.76±53.60) μg/L vs (196.32±39.28) μg/L] and uIL-18[(5.15±0.78) μg/L vs (4.30±0.89) μg/L] in critically ill patients with AKI was higher in renal recove-ries than in renal non-recoveries(P<0.05). The levels of uNGAL and uIL-18 critically ill patients at initiation of CVVH were higher in non-survivors when compared with survivors[(213.50±104.78) μg/L vs (79.91±55.81) μg/L, P<0.05], [(4.48±2.32) μg/L vs (1.94±1.88) μg/L, P<0.05]. The levels of uNGAL and uIL-18 of critically ill patients with AKI at initiation of CVVH were higher in non-survivors than in survivors[(256.99±49.33) μg/L vs (127.11±38.99) μg/L, P<0.05], [(5.48±0.67) μg/L vs (3.65±0.98) μg/L, P<0.05]. The levels of uNGAL and uIL-18 at the first diagnosis time of AKI were higher in non-survivors than in survivors(P<0.05). Conclusions uNGAL and urine IL-18 at commencement of CVVH predicts short-term prognosis in critically ill patients with AKI.uNGAL and urine IL-18 can be as a prognostic value in the prediction of the need for renal replacement therapy initiation or mortality in critically ill patients with AKI. Key words: Neutrophil gelatinase-associated lipocalin; Interleukin-18; Acute kidney injury; Critically ill; Child; Continuous veno-venous hemofiltration