2024, Number 6
Association between serum levels of interleukin 6 and the development of acute kidney injury upon admission to the Intensive Care Unit in patients with severe respiratory distress syndrome
Albuerne EIJ, Aguirre SJS, Martínez DBA
Full text
10.35366/119230
Language: Spanish
References: 10
Page: 439-443
PDF size: 269.58 Kb.
ABSTRACT
Introduction: acute respiratory distress syndrome (ARDS) is a common critical condition in patients admitted to the Intensive Care Unit (ICU), characterized by a widespread inflammatory response and diffuse alveolar damage, leading to severe respiratory failure. Mortality associated with ARDS can exceed 40%, especially in the most severe cases. One of the most frequent complications of ARDS is acute kidney injury (AKI), a rapid deterioration of renal function that contributes to increased mortality and prolonged hospital stays. Interleukin 6 (IL-6) is a proinflammatory cytokine implicated in the systemic inflammatory cascade and organ damage, including the kidneys. However, the role of IL-6 as a biomarker in the development of AKI in patients with severe ARDS remains an area of debate, with previous studies showing mixed results. This study aims to evaluate whether serum levels of IL-6 upon admission can predict the development of AKI in patients with severe ARDS, with the goal of contributing to a better understanding of its clinical value in this critical population. Objectives: to determine whether elevated serum levels of IL-6 upon ICU admission are associated with the development of AKI in patients with severe ARDS. Additionally, to assess the predictive performance of IL-6 for the development of AKI. Material and methods: a retrospective cohort study was conducted in a sample of 98 adult patients diagnosed with severe ARDS, admitted to the ICU at ABC Medical Center between March 2020 and March 2024. Serum levels of IL-6 and creatinine were measured upon admission and at 48 and 72 hours later. Statistical analysis was performed using normality tests and logistic regression analysis to evaluate the association between IL-6 and AKI, as well as ROC curve analysis to assess the predictive performance of IL-6. Results: of the 98 patients, 39.8% (n = 39) developed AKI. The mean age of the patients was 61.5 ± 18.0 years, and AKI was significantly associated with age (p < 0.05), but not with sex. Regarding IL-6 levels upon admission, no statistically significant association was found with the development of AKI (OR: 1.0004; 95%CI 0.999-1.001). ROC curve analysis for IL-6 showed an area under the curve of 0.568 (p = 0.259), indicating a low predictive value for AKI. However, a positive and significant correlation was observed between IL-6 levels and creatinine concentrations at 72 hours (rho = 0.278, p = 0.006), suggesting a possible relationship with renal dysfunction in later stages. Conclusions: although serum IL-6 levels upon admission did not prove to be a significant predictor of AKI development in patients with severe ARDS, the correlation observed between IL-6 and creatinine concentrations at 72 hours suggests that IL-6 may play a role in monitoring renal function at later stages. These findings suggest that IL-6 alone is not sufficient to predict AKI upon admission, but its measurement may complement other renal function markers for the clinical follow-up of these patients. Further studies are needed to explore the role of IL-6 in the evolution of AKI and its potential use as a marker in the management of renal function in critically ill patients.REFERENCES