Diagnostic possibilities of cytokeratin-18 investigation in chronic kidney diseases in children

Abstract

Objective. To evaluate the possibility of using laboratory determination of cytokeratin-18 in the complex diagnosis of chronic kidney diseases in children.

Materials and methods. 137 patients with chronic kidney diseases were examined. The comparison group included conditionally healthy children without signs of kidney damage and autoimmune process. Quantitative determination of cytokeratin-18 levels was performed by enzyme immunoassay.

Results. Differences in cytokeratin-18 concentrations in the blood serum of patients of all groups (p < 0.001), were noted. Differences in cytokeratin-18 levels in urine according to the Kraskel — Wallis test also showed statistical significance (p < 0.001). When the cytokeratin-18 level is > 0.07 in the blood serum, the odds ratio of the risk of chronic kidney disease (OR) is 34.04 (95 % CI (9.5—122)). ROC analysis showed diagnostic accuracy of 85.0 % (95 % CI (76.9—93.1)), sensitivity — 81.6 %, specificity — 88.5 %. With cytokeratin-18 levels > 0.09 in urine, the OR was 26.5 (95 % CI (8.4—84.3)), diagnostic accuracy was 83.7 % (95 % CI (74.9—92.6)), sensitivity was 73.8 %, and specificity was 84.6 %.

Conclusion. Determination of cytokeratin-18 levels in the blood serum and urine of pediatric patients can be used in the diagnosis of chronic kidney diseases in children, including for the differential diagnosis of glomerular and non-glomerular chronic kidney diseases, as well as glomerulopathies among themselves. However, it is not possible to use this marker of apoptosis to predict the progression of the disease and assess the severity of the process at this stage of the study.