Purpose In this study, we focused on the role of elevated serum interleukin 6 (IL-6) concentration in predicting 5-year cardiovascular mortality in hemodialysis patients using low-flux dialyzer reuse. Materials and methods We measured serum IL-6 concentrations in 236 hemodialysis patients (138 males and 98 females) to predict 5-year cardiovascular mortality. We assessed the baseline demographics of all patients who had a mean age of 44 years and a median hemodialysis duration of 38.5 months. We divided all patients into two equal groups based on the serum IL-6 concentration: G1 (n = 118) with serum IL-6 concentration < 6.78 pg/L and G2 (n = 118) with serum IL-6 concentration ≥ 6.78 pg/L. Results After the 5-year follow-up, 45 patients died due to cardiovascular causes (19.1%). Lipid disorder, hemoglobin, serum albumin, β2-M, and IL-6 concentration were independent risk factors for predicting cardiovascular mortality during the 60-month follow-up in hemodialysis patients. Based on the Kaplan-Meier analysis, we realized that patients with a higher interleukin 6 concentration (G2) had a significantly higher cardiovascular mortality rate than patients in G1 (log-rank test p < 0.001). Serum IL-6 concentration was a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in hemodialysis patients using low-flux dialyzer reuse (AUC = 0.818; p < 0.001; cut-off value: 8.055 pg/ mL, Se = 77.8%, Sp = 78.5%). Conclusion Serum IL-6 concentration was a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in maintenance hemodialysis patients using low-flux dialysis reuse.
Background. To evaluate the ratio of acute kidney injury (AKI) to chronic kidney disease (CKD) in sepsis-associated acute kidney injury (SA-AKI) patients of the intensive care unit (ICU) and predictive value of neutrophil gelatinase-associated lipocalin (NGAL) measured at the admission time in the progression of AKI to CKD. Methods. A study of 121 consecutive adult patients admitted to the intensive care unit (ICU) diagnosed as SA-AKI. AKI and CKD were defined based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula. Serum and urine NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with a blood sample taken at hospital admission time. Results. The ratio of AKI to CKD in SA-AKI patients was 22.3%. Mean concentration of serum and urine NGAL in AKI to the CKD group was 790.99 ng/ml and 885.72 ng/ml, higher significantly than those of recovery patients (351.86 ng/ml and 264.68 ng/ml), p<0.001. eGFR, both serum and urine NGAL had a predictive value for AKI to CKD (eGFR: AUC=0.857, Se=74.1%, Spe=92.6%, p<0.001. Serum NGAL: AUC=0.868, Se=77.8%, Spe=91.5%. Urine NGAL: AUC=0.869, Se=77.8%, Spe=92.6%, p<0.001. Conclusion. Serum and urine NGAL, measuring at hospital admission time, were good prognostic biomarkers of AKI to CKD in SA-AKI patients.
Tumor necrosis factor alpha (TNF‐α) is an inflammatory cytokine produced during acute inflammation. Few studies have evaluated the association between serum TNF‐α and its receptors and their clinical outcomes in hemodialysis patients. However, a study assessing patients using a low‐flux dialyzer reuse has not been conducted yet. The serum TNF‐α concentrations of 319 prevalent hemodialysis patients (mean age, 45 ± 15 years; median duration of hemodialysis, 48 [interquartile range, 26‐79] months; 185 males and 134 females) was examined to predict their 3‐year mortality. The patients were divided into tertiles according to their serum TNF‐α concentrations: T1 (n = 106; serum TNF‐α concentration, <41.22 pg/mL), T2 (n = 106; serum TNF‐α level, from 41.22 to 67.28 pg/mL), and T3 (n = 107; serum TNF‐α concentration, ≥ 67.29 pg/mL). During the 36‐month follow‐up period, a total of 50 (15.7%) patients died from all causes. The Kaplan‐Meier analysis revealed that the all‐cause mortality in T3 was significantly higher compared to that in T1 and T2 (log‐rank test, P < .001). The serum TNF‐α level was a significant predictor for all‐cause mortality (area under the curve = 0.887, P < .001, cutoff value, 89.812 pg/mL, sensitivity = 76%, specificity = 96.3%). The serum TNF‐α level was a better predictor of mortality than the duration of hemodialysis and serum albumin, serum high‐sensitivity C‐reactive protein, and serum beta‐2 microglobulin concentrations. The serum TNF‐α concentration was a good predictor of the 3‐year mortality in low‐flux hemodialysis patients.
Aims: Carpal tunnel syndrome (CTS) and low serum prealbumin concentration are common in maintenance hemodialysis patients. In this study, we focused on the association between low serum prealbumin levels and carpal tunnel syndrome in maintenance hemodialysis (MHD) patients using low-flux dialysis reuse. Materials and methods: Serum prealbumin levels were assessed to determine the association between low serum prealbumin levels and CTS in 373 prevalent MHD patients (the mean age was 45 years old, hemodialysis duration was 46 months). The patients were divided into 2 groups: the CTS group with 44 patients and the non-CTS group with 329 patients. Results: The prevalence of CTS was 11.8%. Serum prealbumin showed a good prognostic value to predict CTS in MHD patients using low-flux dialysis reuse (the Area Under the Curve ¼ 0.841, p < .001; cutoff value: 26.5 mg/dL with sensitivity ¼ 72.7% and specificity ¼ 79.9%). Conclusions: Serum prealbumin was a good prognostic biomarker of CTS in MHD patients using low-flux dialysis reuse.
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