Interleukin-6 Is a Predictor of Mortality in Stable Hemodialysis Patients

Hasuike, Yukiko; Nonoguchi, Hiroshi; Ito, Katsukiyo; Naka, Miki; Kitamura, Rie; Nanami, Masayoshi; Tokuyama, Masanori; Kida, Aritoshi; Otaki, Yoshinaga; Kuragano, Takahiro; Nakanishi, Takeshi

doi:10.1159/000235687

Cited by 39 publications

(36 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since IL-6 is accepted as a negative predictive factor for mortality in HD patients [1,3], it is possible that in stable HD patients a mild degree of acidosis is in fact a positive marker as stated by large cohort studies [11,19]. This is supported by our data which showed a better nutritional state in the patients with acidosis, as reflected by a higher protein catabolic rate and transferrin.…”

Section: Discussionsupporting

confidence: 80%

See 1 more Smart Citation

Cytokine Secretion and Markers of Inflammation in Relation to Acidosis among Chronic Hemodialysis Patients

Ori

Bergman²,

Bessler

et al. 2013

Blood Purif

View full text Add to dashboard Cite

Background: Various cytokines are increased in hemodialysis (HD) patients, and are considered prognostic markers. Metabolic acidosis is common among chronic HD patients and is associated with survival. The relationship between acidosis and cytokines in HD patients has not been fully explored. The study aim was to measure pro- and anti-inflammatory cytokines in HD patients, with relation to bicarbonate levels. Methods: Forty-seven stable HD patients were included (male/female 28/19, mean age 70.4 ± 14.5 years). Blood tests were taken before a midweek dialysis session. Cytokine secretion from peripheral blood mononuclear cells was measured. Results: Acidosis versus no acidosis (serum HCO₃^- 21.5 ± 0.2 vs. 24.9 ± 0.3 mEq/l, p < 0.001) was associated with decreased secretion of the anti-inflammatory interleukin-10 (IL-10, 1.16 ± 0.11 vs. 1.71 ± 0.20 ng/ml, p = 0.023). Patients with acidosis had higher parathyroid hormone (PTH), calcium-phosphate product, protein intake and transferrin. Higher IL-10 was associated with increased IL-6 secretion, higher bicarbonate, younger age and lower PTH. Conclusions: In stable chronic HD patients, a possible direct relation exists between metabolic acidosis and IL-10.

show abstract

Section: Discussionsupporting

confidence: 80%

“…The proinflammatory interleukin-6 (IL-6) increases during HD and has been associated with cardiovascular mortality, malnutrition and resistance to erythropoietin (EPO) in HD patients [1,2]. IL-6 is considered a prognostic marker among these patients [3]. IL-10 is an anti-inflammatory cytokine, operating as a counterregulatory mediator.…”

Section: Introductionmentioning

confidence: 99%

Cytokine Secretion and Markers of Inflammation in Relation to Acidosis among Chronic Hemodialysis Patients

Ori

Bergman²,

Bessler

et al. 2013

Blood Purif

View full text Add to dashboard Cite

show abstract

“…The majority of chronic hemodialysis (HD) patients have elevated serum levels of inflammatory markers (1,2) that are powerful predictors of mortality in this population (2)(3)(4)(5)(6)(7). A generalized increase in the inflammatory response in patients with ESRD may occur via decreased clearance of proinflammatory cytokines, volume overload, oxidative and carbonyl stress, patient-related mechanisms (underlying disease and comorbidities), as well as factors related to dialysis technique.…”

Section: Introductionmentioning

confidence: 99%

“…These mechanisms of possible causes of inflammation in ESRD patients are discussed elsewhere (8 -10). Among the various cytokines, IL-6 was found to be most closely related to mortality (3,4,6,7) and to be associated with more causes of inflammation than other cytokines and Creactive protein (CRP) (11,12). While an experimental study by Ling et al (13) suggested that protein-energy wasting (PEW) produces changes in inflammationrelated protein characteristics of a low-grade systemic inflammatory response, clinical studies (14 -16) found inflammation, PEW, and cardiovascular morbidity to be interrelated in HD patients, each additionally contributing to the high mortality in HD patients.…”

Section: Introductionmentioning

confidence: 99%

IL-6 Levels, Nutritional Status, and Mortality in Prevalent Hemodialysis Patients

Beberashvili

Sinuani

Azar

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives The influence of serum IL-6 levels on nutritional status in chronic hemodialysis (HD) patients remains to be elucidated. The present report describes a prospective longitudinal study of IL-6 levels and nutritional parameters to determine whether high IL-6 levels are independently associated with nutritional status over time in a cohort of prevalent hemodialysis patients.Design, setting, participants, & measurements 85 clinically stable hemodialysis patients (37.6% women), with a mean age of 66.5 Ϯ 10.6 years, were studied after exclusion of patients with BMI Ͻ 20 kg/m 2 and/or serum albumin Ͻ35 g/L. IL-6, dietary energy and protein intake, and biochemical markers of nutrition and body composition (anthropometry and bioimpedance analysis) were measured at baseline and at 6, 12, 18, and 24 months following enrollment. Observation of this cohort was continued over 2 additional years.Results IL-6 levels increased with time in both unadjusted (linear estimate: 2.57 Ϯ 0.44 pg/ml per 2 yrs; P ϭ 0.001) and adjusted models (linear estimate: 2.35 Ϯ 0.57 pg/ml per 2 yrs; P ϭ 0.049). Significant reductions of daily energy intake, laboratory markers (albumin, transferrin, cholesterol, creatinine), and body composition (fat mass) with higher IL-6 levels were observed over the duration of the longitudinal observation period. However, none of the studied parameters were associated with changes in IL-6 levels over time (IL-6-by-time interactions were NS). Furthermore, cumulative incidences of survival were correlated with the baseline serum IL-6 levels (P ϭ 0.004 by log-rank test). Finally, for each pg/ml increase in IL-6 level, the hazard ratio for death from all causes was 1.06 (95% CI 1.01 to 1.10) after adjustment for demographic and clinical parameters. ConclusionsOur results suggest that higher serum IL-6 levels are associated with all-cause mortality without additional changes in clinical and laboratory markers of nutritional status in clinically stable HD patients.

show abstract

“…Second, study participants underwent coronary angiography, and so they may not be representative of all dialysis patients. Third, we did not measure other biomarkers associated with mortality and cardiovascular events in dialysis patients, such as levels of interleukin 6, fibroblast growth factor 23, homocysteine and soluble isoform of Flt-1 [34,35,36,37,38], although the HRs of adverse events for PlGF were not attenuated after adjustment for BNP and CRP levels.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Placental Growth Factor on Mortality and Cardiovascular Events in Dialysis Patients

Matsui

Samejima²,

Takeda³

et al. 2015

Am J Nephrol

View full text Add to dashboard Cite

Background: Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, has recently emerged as a predictor of survival and cardiovascular risk. Along with others, we have shown an independent association between PlGF and cardiovascular events in CKD patients, but not much is known about patients receiving dialysis. Methods: We studied 205 dialysis patients undergoing cardiac catheterization at the Nara Medical University between April 1, 2004, and December 31, 2012. Serum levels of PlGF and VEGF were measured with ELISA in all the patients. Results: During a median follow-up of 20 months, 121 participants died from any cause or experienced a cardiovascular event. In the fully adjusted analysis, having an above-median PlGF or VEGF level was associated with a hazards ratio for adverse outcomes of 2.55 (1.72-3.83) and 1.39 (0.95-2.04), respectively. Using a multimarker strategy in a model with age, serum albumin, history of coronary artery disease, brain natriuretic peptide and PlGF, patients with 2, 3 and 4 positive markers had a 3.82-, 5.77- and 6.59-fold higher risk of mortality or a cardiovascular event, respectively, compared to those with no positive markers. The model with PlGF had a significantly higher c-statistic, integrated discrimination improvement index and category-free net reclassification improvement index than the model without PlGF. Conclusion: PlGF is independently associated with mortality and cardiovascular events, but the association between VEGF and adverse events was attenuated with covariate adjustment. The addition of PlGF to models with established clinical predictors provides additional useful prognostic information in patients receiving dialysis.

show abstract

Interleukin-6 Is a Predictor of Mortality in Stable Hemodialysis Patients

Cited by 39 publications

References 55 publications

Cytokine Secretion and Markers of Inflammation in Relation to Acidosis among Chronic Hemodialysis Patients

Cytokine Secretion and Markers of Inflammation in Relation to Acidosis among Chronic Hemodialysis Patients

IL-6 Levels, Nutritional Status, and Mortality in Prevalent Hemodialysis Patients

Prognostic Impact of Placental Growth Factor on Mortality and Cardiovascular Events in Dialysis Patients

Contact Info

Product

Resources

About