Makinde RA, Ajose AO, Ajeigbe AK, Adedeji TA, Onakpoya UU, Ojo OO. Pediatric cardiac surgery associated-acute kidney injury: Interleukin 18 as a new biomarker. World J Nephrol 2026; 15(2): 117015 [DOI: 10.5527/wjn.v15.i2.117015]
Corresponding Author of This Article
Ronke Adunni Makinde, Consultant, Principal Investigator, Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ilesa Road, Ile ife 220282, Osun, Nigeria. ronkeomoola@yahoo.com
Research Domain of This Article
Urology & Nephrology
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research-article
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Makinde RA, Ajose AO, Ajeigbe AK, Adedeji TA, Onakpoya UU, Ojo OO. Pediatric cardiac surgery associated-acute kidney injury: Interleukin 18 as a new biomarker. World J Nephrol 2026; 15(2): 117015 [DOI: 10.5527/wjn.v15.i2.117015]
Ronke Adunni Makinde, Abiodun Olabamiji Ajose, Abiodun Kofoworola Ajeigbe, Tewogbade Adeoye Adedeji, Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ile ife 220282, Osun, Nigeria
Uvie Ufuoma Onakpoya, Olugbenga Olalekan Ojo, Department of Surgery, Cardiothoracic Unit, Obafemi Awolowo University Teaching Hospital Complex, Ile ife 220282, Osun, Nigeria
Author contributions: Makinde RA contributed to conceptualization, original draft writing, and funding; Makinde RA and Ajose AO contributed to methodology; Makinde RA, Ajeigbe AK, and Onakpoya UU contributed to investigation; Ajose AO, Ajeigbe AK, Adedeji TA, Onakpoya UU, and Ojo OO revised the manuscript; Ajose AO and Ojo OO contributed to supervision; Ajose AO, Adedeji TA, and Onakpoya UU participated in project administration; Ajeigbe AK contributed to formal analysis; Ojo OO contributed to visualization. All authors have read and approved the final manuscript.
Institutional review board statement: Ethical approval for this study was gotten from the hospital Ethical Committee (ERC/2020/03/16).
Clinical trial registration statement: The study is a longitudinal study but not a randomized clinical trial as such no intervention was done so the clinical trial registration statement is not applicable.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: It’s not applicable.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Access to the data will be provided in accordance with institutional and ethical guidelines, ensuring confidentiality and privacy of participants.
Corresponding author: Ronke Adunni Makinde, Consultant, Principal Investigator, Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ilesa Road, Ile ife 220282, Osun, Nigeria. ronkeomoola@yahoo.com
Received: November 27, 2025 Revised: December 24, 2025 Accepted: February 6, 2026 Published online: June 25, 2026 Processing time: 198 Days and 18.6 Hours
Abstract
BACKGROUND
Creatinine has been the widely accepted and used marker of cardiac surgery associated (CSA) acute kidney injury (AKI) in both adult and pediatric age groups, the diagnosis of which may take hours to days, leading to delayed recognition of renal dysfunction, and this may be partly responsible for the limited progress in preventing and treating postoperative AKI. This underscores the need for more sensitive markers of AKI.
AIM
To assess the detection of AKI by interleukin 18 (IL-18) in contrast to creatinine among post-operative CSA children in Nigeria.
METHODS
Plasma samples were collected from forty consecutive children aged less than 15 years who had open heart surgery for treatment of congenital heart disease at six different time points (0-, 4-, 8-, 12-, 24-, 48 hours) and were assayed for IL-18 and creatinine using enzyme linked immuno-sorbent assay method and automated Jaffe kinetic method respectively.
RESULTS
The average plasma IL-18 concentrations at six different time points were 12.83 ng/L, 19.09 ng/L, 22.15 ng/L, 20.00 ng/L, 18.11 ng/L and 16.36 ng/L correspondingly with the greatest value at 8 hours. Receiver operating characteristic curve showed that IL-18 portend CSA-AKI with a specificity of 88% and a sensitivity of 100% at a limit point of 22 ng/L and had an area under the curve of 0.926.
CONCLUSION
IL-18 had a better specificity and sensitivity in the detection of CSA-AKI in pediatric age group than creatinine from the findings in this study.
Core Tip: In the present study, we have shown that interleukin 18 had an earlier rise than the traditional creatinine in those patients who developed cardiac surgery associated acute kidney injury after open heart surgery, and that it is also a better diagnostic marker with its superior area under the curve value on receiver operating characteristic curve than creatinine, thus, our findings underscore the importance of using this biomarker in the diagnosis of cardiac surgery associated acute kidney injury for earlier diagnosis and improved patient outcome.
