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Pediatric cardiac surgery associated-acute kidney injury: Interleukin 18 as a new biomarker

Ronke Adunni Makinde1, Abiodun Olabamiji Ajose2, Abiodun Kofoworola Ajeigbe2

  • 1Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ile ife 220282, Osun, Nigeria. ronkeomoola@yahoo.com.

World Journal of Nephrology
|July 3, 2026
PubMed

Insights

Interleukin 18 (IL-18) shows higher sensitivity and specificity for detecting cardiac surgery-associated (CSA) acute kidney injury (AKI) in children compared to creatinine. This new marker offers a more accurate and timely diagnosis for pediatric AKI post-surgery.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Surgery
  • Biomarker Discovery

Background:

  • Creatinine is the standard but delayed marker for cardiac surgery-associated (CSA) acute kidney injury (AKI).
  • Delayed AKI diagnosis in pediatric patients hinders effective treatment and prevention strategies.
  • There is a critical need for more sensitive and rapid AKI biomarkers in pediatric cardiac surgery.

Purpose of the Study:

  • To evaluate the diagnostic performance of interleukin 18 (IL-18) against creatinine for detecting AKI in Nigerian children post-cardiac surgery.
  • To compare the sensitivity and specificity of IL-18 and creatinine in identifying pediatric CSA-AKI.

Main Methods:

  • Plasma samples were collected from 40 pediatric patients (<15 years) undergoing open-heart surgery.
  • Samples were analyzed for IL-18 and creatinine at six time points within 48 hours post-surgery.
  • IL-18 was measured using ELISA, and creatinine was measured using the automated Jaffe kinetic method.

Main Results:

  • Plasma IL-18 concentrations peaked at 8 hours post-surgery, reaching an average of 22.15 ng/L.
  • IL-18 demonstrated high diagnostic accuracy for CSA-AKI, with 100% sensitivity and 88% specificity at a 22 ng/L threshold.
  • The area under the receiver operating characteristic curve (AUC) for IL-18 was 0.926, indicating excellent performance.

Conclusions:

  • Interleukin 18 (IL-18) is a more sensitive and specific biomarker for detecting CSA-AKI in pediatric patients than creatinine.
  • IL-18 offers a promising tool for early and accurate diagnosis of AKI in children following cardiac surgery.
  • Findings support the potential clinical utility of IL-18 for improved management of pediatric CSA-AKI.
Abstract

Keywords:
Acute kidney injuryCardiac surgeryCreatinineInterleukin 18PediatricReceiver operating characteristic curve

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