Interleukin-10: Genetic and biochemical prediction of sepsis-induced acute kidney injury in critically ill patients in intensive care unit: A cross-sectional study.

Abstract

Background: Sepsis is a potentially life-threatening condition that eventually causes multiorgan dysfunction in critically ill patients. Acute kidney injury (AKI) is a severe life-threatening complication of sepsis, a condition termed sepsis-induced AKI (S-AKI), with poor clinical outcomes and high mortality rates. Inflammatory and immunological responses are important variables in S-AKI. This study aimed to examine the relationship of rs1518111 polymorphism in the interleukin-10 ( IL-10 ) gene and serum/urine IL-10 levels with sepsis-induced AKI in critically ill patients in the intensive care unit (ICU).

Methods: In this cross-sectional study, 310 critically ill adult patients were recruited, of whom, 197 developed S-AKI. Real-time polymerase chain reaction was performed to detect the rs1518111 polymorphism. Circulating blood and urine IL-10 levels of IL-10 were measured.

Results: For rs1518111 SNP, the presence of at least one T allele increased the risk of occurrence of S-AKI (odds ratio [OR]: 1.34, 95% CI: 1.07-3.17; p < 0.001), regardless of the type of infection and severity of sepsis. Blood and urine IL-10 levels were an excellent prediction of S-AKI (area under the receiver operating characteristic curve [AUC]: 0.881 and 0.953 and sensitivity: 90.2% and 97.6% at cutoff of 133.5 and 5.67 pg/mL, respectively). Regression analysis showed that white blood cell count and increased blood and urine IL-10 levels, in addition to the presence of TT genotype, are independent risk factors for S-AKI.

Conclusion: rs1518111 polymorphism in the IL-10 gene is a risk factor for sepsis-induced AKI in the ICU. Serum/urine IL-10 levels may be used as predictors of S-AKI in critically ill patients with sepsis, thereby improving early management.