Serum IL-18 as a predictive biomarker for acute kidney injury in sepsis patients

Satya Pratama; Heri Sutanto; Nur Samsu

doi:10.69863/dim.2025.e643

Authors

Satya Winnu Pratama Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
Heri Sutanto Division of Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
Nur Samsu Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia

DOI:

https://doi.org/10.69863/dim.2025.e643

Keywords:

interleukin-18, biomarker, predictor, acute kidney injury, sepsis

Abstract

BACKGROUND: Sepsis is a syndrome that can result in multiorgan dysfunction, including acute kidney injury (AKI). AKI is a serious complication of sepsis, and its incidence ranges from 30% to 50%. Newer predictive biomarkers such as serum interleukin-18 (IL-18) are being evaluated as early diagnostic markers with potentially greater sensitivity than serum creatinine.

OBJECTIVES: To evaluate the usefulness of serum IL-18 levels as a predictive biomarker for AKI in patients with sepsis.

METHODS: The cross-sectional study was conducted at Dr. Saiful Anwar General Hospital and included 68 sepsis patients, 34 with AKI and 34 without AKI. The serum level of IL-18 was measured using the ELISA method. AKI diagnosis was made according to the KDIGO criteria. The Mann-Whitney test, Spearman correlation, and receiver operating characteristic (ROC) curve analysis were included in the statistical analysis.

RESULTS: The results showed that serum IL-18 levels were significantly greater in the AKI group compared with the non-AKI group (49.88 ± 50.87 vs. 19.89 ± 10.40; p < 0.001). A significant positive correlation was observed between serum IL-18 levels and the risk of AKI (r = 0.505; p < 0.001). ROC analysis revealed an area under the curve (AUC) of 0.792 with 82.4% sensitivity and 64.7% specificity at a cut-off value of 23.81 pg/mL. Logistic regression revealed that with each 1-unit increase in serum IL-18, a 7.3% increase in the risk of developing AKI was observed.

CONCLUSION: Serum IL-18 has good potential to serve as a predictive biomarker for AKI in sepsis patients, with reasonable diagnostic accuracy.

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