Urinary IL-18 is a biomarker that is elevated in patients with acute tubular necrosis and does not seem to be affected by prerenal azotemia or chronic kidney disease. The present study was designed to evaluate the diagnostic utility of urinary IL-18 as an early marker of AKI in critically ill patients. A total of 120 critically ill patients were included in this observational prospective randomized study. All patients were subjected to a measurement of Urinary IL-18 and the sCr at fashioned

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... intervals to assess which can predict early renal impairment. There was a significant difference in urinary IL-18 level between patients with AKI and patients who did not develop AKI on admission and 6 and 24 hours from admission (p ˂ 0.001 for all). Moreover, there was a significant increase of urinary IL-18 level after 6 and 24 hours in both group (p ˂ 0.001 for all). There was no significant difference in sCr level on admission and after 6 hours between both groups (p=0.817 and 0.760 respectively), while after 24 and 48 hours, sCr level was significantly higher in AKI group (p ˂ 0.001 for both). Serum Cr level start to increase significantly after 24 hours in AKI group (p ˂ 0.001). The most sensitive in detecting AKI was urinary IL-18 after 6 and 24 hours of the admission with a sensitivity of 100% and a specificity of 100%. So urinary IL-18 can be used as a test for the early diagnosis of AKI in critically ill patients. Key words: Urinary IL-18, acute kidney injury, APACHE II REFERENCES De Mendonca A, Vincent J, Suter P, et al. (2000). Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score. Intensive Care Medicine. 26 (7): 915–921. Ympa Y , Sakr Y, et al. (2005). Has mortality from acute renal failure decreased? A systematic review of the literature. Am J Med. 118: 827–832. Vinsonneau C, Camus C, Combes A, et al. (2006). Continuous venovenous haemodia-filtration versus intermittent haemodialysis for acute renal failure in patient [...]