Recenzija, Prikaz slučaja
https://doi.org/10.22514/SV142.102018.1
A prognostic value of early urinary biomarkers NGAL and IL-18 in critically ill children: a 10-year literature review
Diana Dobiliene
; Department of Paediatrics, Medical Academy, Lithuanian University of Health Sciences
Sarunas Rudaitis
Rimantas Kevalas
Jurate Masalskiene
Sažetak
Introduction. Acute kidney injury (AKI)
is a life-threatening syndrome caused by
a sudden and rapidly progressing impairment of renal function. It is a common and complicated clinical entity among hospitalized children, occurring in 2%-4.5% of children treated in a pediatric intensive
care unit. Mortality among such patients remains high (from 8% to 89%) despite improving patient care and technical possibilities. Te stage of renal damage is a reversible process, and its timely detection
would prevent the progression of renal damage and thus reduce pediatric mortality rates. Terefore, modern medicine necessitates the identifcation of novel AKI biomarkers that would correlate with renal
cell damage and could be detected earlier than a rise in serum creatinine (sCr). Neutrophil gelatinase-associated lipocalin (NGAL) and interleukin 18 (IL-18) are one of such early markers of AKI.
Aim. To carry out a literature review of studies on changes in NGAL and IL-18 levels in the urine of critically ill patients and to determine a prognostic value of these biomarkers in the detection of renal injury
and impact on disease outcomes. Material and methods. Tis literature
review includes the publications of biomedical studies assessing early biomarkers of AKI in urine (uNGAL or uIL-18) of critically ill children, published in English during the 10-year period. Search for publication was performed in the PubMed database.
Results. Analysis included 10 studies that investigated early biomarkers of AKI(NGAL or IL-18) in urine of critically ill children and compared them with sCr.
Among the biomedical studies analyzed in our literature review, 9 measured the NGAL level in urine or both in urine and serum, while 2measured IL-18 in urine.
It was determined that uNGAL and uIL18 were good early diagnostic biomarkers of AKI, which increased 48 h earlier than
Cr in serum (P<0.005). Te meta-analysis carried out by Haase et al. showed that uNGAL predicted the development of AKI better in critically ill children than in adults (OR, 25.4; ROC, 0.930 vs. OR, 10.6;
ROC, 0.782). Tree studies reported that the uNGAL level in study populations with AKI directly depended on disease severity
and AKI degree (P<0.005). Four studies found that uNGAL and one study that uIL18 are good predictive factors of mortality (P<0.005).
Conclusions. uNGAL and uIL-18 are early predictive biomarkers of AKI in critically ill children. uNGAL and uIL-18 level correlated well with disease severity and are independent predictive biomarkers of
mortality.
Ključne riječi
acute kidney injury; critically ill children; biomarkers; uNGAL; uIL-18
Hrčak ID:
217583
URI
Datum izdavanja:
1.11.2018.
Posjeta: 782 *