Critical Care and Shock

The relationship of severity of inflammation with the incidence of acute kidney injury in septic patients in the intensive care units: Review of C-reactive protein and interleukin-6

Abstract

Objective: To know the relationship between the occurrence of acute kidney injury (AKI) in patients with sepsis concerning the severity of inflammation. In this study, interleukin-6 (IL-6) and C-reactive protein (CRP) markers represented the severity of inflammation. Furthermore, the researchers wanted to see whether this inflammatory marker in the serum of septic patients in the intensive care unit (ICU) could predict the occurrence of AKI in the future.

Design: This study was a prospective cohort nested-case control study, namely a case-control study conducted in a cohort population.

Setting: This research has been carried out in the ICU of Dr. Wahidin Sudirohusodo Hospital Makassar and Hasanuddin University Hospital. Serum IL-6 examination was carried out in the Hasanuddin University Hospital laboratory.

Patients and participants: This study’s samples were septic patients treated in the ICU of Dr. Wahidin Sudirohusodo Hospital Makassar and Hasanuddin University Hospital Makassar starting from January 2021. The sample selection was carried out consecutively, namely the selection of respondents based on the arrival of patients treated in the ICU until fulfilled.

Measurement and results: We used the Mann-Whitney test for data analysis in this study. There was a significant difference in serum IL-6 and CRP levels between the two groups on day 0 and day 3 of ICU admission and changes from day 0 to day 3, whereas changes in CRP levels from day 0 to day 3 were a good predictor of AKI, with a cut-off value of 17.75 mg/l.

Conclusions: In this study, CRP and IL-6 levels could be used to predict AKI. IL-6 and CRP had an essential role in the inflammatory response and helped to predict clinical outcomes in patients with AKI.