Role of interleukin-18 and plasma B-type natriuretic peptide in predicting requirement of kidney replacement therapy and/or mortality in individuals with acute heart disorders

Introduction: although many predictive tools have already been developed, efforts are still proceeding to identify a reliable biomarker to predict the prognosis of the patients with acute heart disorders.objectives: the aim was to evaluate the role of renal injury biomarkers (serum cystatin c, serum and urine interleukin-18, il-18) and heart failure biomarkers (plasma b-type natriuretic peptide, bnp) in the prediction of the postdischarge requirement of renal replacement therapy (rrt) and/or 6-month mortality in patients with acute heart disorders.patients and methods: in patients diagnosed with acute heart disorders (acute heart failure [ahf] and/or acute coronary syndrome [acs]) and admitted to the intensive care units, baseline clinical parameters, renal and cardiac biomarkers were determined. patients were followed up for 6 months. the composite outcome was the postdischarge requirement of rrt and/or 6-month mortality.results: of 120 patients, 5.8% continued rrt after discharge. the 6-month mortality was 20%. cox logistic regression analysis showed that urine il-18 (p = 0.021), plasma bnp (p = 0.046), acute physiology and chronic health evaluation (apache) ii score (p = 0.002), and left ventricular diastolic dysfunction (p = 0.045) were independent predictors of the postdischarge requirement of rrt and/or 6-month mortality. for predicting rrt and/or 6-month mortality, using urine il-18 cutoff value of 29.1 pg/ml showed 66.7% sensitivity and 67.7% specificity (area under the curve, auc 0.70, p = 0.003), while using plasma bnp cutoff value of 881.6 pg/ml showed 66.7% sensitivity and 70.8% specificity (auc 0.76, p < 0.001).conclusion: urine il-18 and plasma bnp are independently predictive for the postdischarge requirement of rrt and/or 6-month mortality in patients with acute heart disorders.