Assessing the value of serum and urinary interleukins for diagnosis of acute kidney injury in children and adolescents: A systematic review and meta-analysis.

ABSTRACT

INTRODUCTION: Several studies have questioned the diagnostic utility of interleukins (IL) in detecting acute kidney injury (AKI) in pediatric population. Therefore, the present systematic review and meta-analysis aims to assess the diagnostic value of ILs in pediatric AKI patients. METHOD: Two independent researchers screened records acquired through searching in Medline, Embase, Scopus, and Web of Science, until the end of 2020. Articles evaluating serum and urinary levels of ILs in AKI patients were included in this study. Data were extracted and analyzed using STATA software. RESULTS: Twenty-one studies were included. Analyses showed that AUC, sensitivity, specificity and diagnostic odds ratio of urinary IL-18 for diagnosing AKI were 0.77 (95% CI 0.74, 0.81), 0.64 (95% CI 0.32, 0.87), 0.75 (95% CI 0.62, 0.85) and 6 (95% CI 1, 23), respectively. Those values were 0.79 (95% CI 0.75, 0.83), 0.58 (95% CI 0.37, 0.76), 0.87 (95% CI 0.66, 0.96), and 9 (95% CI 4, 20) for serum IL-6, and 0.72 (95% CI 0.68, 0.76), 0.53 (95% CI 0.34, 0.72), 0.79 (95% CI 0.60, 0.91) and 4 (95% CI 2, 8) for serum IL-8, respectively. Urinary levels of ILs 6, 8 and 10 were not significantly different between AKI patients and the non-AKI control group. Serum levels of ILs 10 and 18 were not adequately evaluated in the studies. CONCLUSION: IL-18 urinary levels and IL-6 and IL-8 serum levels are significantly higher in AKI patients compared to the non-AKI group. However, their low sensitivity and specificity in detecting AKI questions their diagnostic value.