Predictive Value of Urinary IL-18 Level in Patients with Coronary Heart Disease for Acute Kidney Injury after PCI

YANG Yunlong; YANG Ning; LI Yue; SI Dingran

doi:10.12102/j.issn.1672-1349.2025.20.018

Abstract：Objective: To explore the predictive value of urinary interleukin (IL)-18 levels in patients with coronary heart disease for the risk of acute kidney injury (AKI) after percutaneous coronary intervention (PCI). Methods: A total of 109 patients with coronary heart disease who were treated at our hospital from September 2021 to September 2023 were selected as the study subjects and all underwent PCI. The occurrence of AKI after PCI was recorded, and the patients were divided into AKI group and non-AKI group according to whether AKI occurred. The serum creatinine levels and urinary IL-18 levels immediately after surgery and at 2, 6, 12, and 24 hours post-surgery were compared between the two groups. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of urinary IL-18 levels for the risk of AKI after PCI. Results: Within 48 hours after PCI, 23 patients had a serum creatinine level increased by ≥0.3 mg/dL (26.5 μmol/L) compared to baseline values, and they were included in the AKI group, while the remaining 86 patients were included in the non-AKI group. The proportion of diabetes mellitus and contrast agent dose were higher in the AKI group than in the non-AKI group (P < 0.05). There was no statistically significant difference in serum creatinine levels immediately after surgery and at 2 and 6 hours post-surgery between the two groups (P > 0.05). However, the serum creatinine levels at 12, 24, and 48 hours post-surgery in the AKI group were higher than those immediately after surgery and higher than those in the non-AKI group (P < 0.05). There was no statistically significant difference in urinary IL-18 levels immediately after surgery between the two groups (P > 0.05), but the urinary IL-18 levels at 2, 6, 12, and 24 hours post-surgery in the AKI group were higher than those immediately after surgery and higher than those in the non-AKI group (P < 0.05). ROC curves were drawn based on serum creatinine levels and urinary IL-18 levels at 2 hours post-surgery. The results showed that the area under the curve (AUC) for predicting AKI after PCI using urinary IL-18 levels at 2 hours post-surgery was 0.837 [95% CI (0.754, 0.901)], which was higher than the AUC of 0.523 [95% CI (0.425, 0.619)] for serum creatinine levels at 2 hours post-surgery. Conclusion: Urinary IL-18 levels can predict the risk of AKI after PCI in patients with coronary heart disease. Early monitoring of urinary IL-18 levels after surgery helps in the early identification of AKI.