| Inflammation markers, adhesion molecules, and all-cause and cardiovascular mortality in patients with ESRD: searching for the best risk marker by multivariate modeling. | |
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MedLine Citation:
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PMID: 15938042 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Inflammation is a major risk factor for mortality and cardiovascular (CV) complications in patients with ESRD. The predictive value of C-reactive protein (CRP) of the main proinflammatory cytokines (IL-1beta, IL-6, IL-18, and TNF-alpha) and of two adhesion molecules (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1) in 217 dialysis patients was compared. Serum IL-6 and CRP added significant prediction power to the multivariate Cox model of all-cause death, and the gain in the prediction power attributable to IL-6 was approximately two times higher than that of CRP. Patients in the third tertiles of serum IL-6 and CRP had a relative risk of all-cause mortality 2.5 and 1.8 times higher than those in the first corresponding tertiles, and there was no statistical difference between these two relative risks. The gain in prediction power associated with TNF-alpha, IL-beta, IL-18, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 was of small degree (P = NS). Similarly, serum IL-6 added the highest prediction power to the CV death model, and the IL-6 attributable gain was approximately two times higher than that of serum CRP. However, the risk estimate for CV mortality of patients with high serum IL-6 did not differ significantly from that of patients with high serum CRP. IL-6 adds significantly greater predictive power for all-cause and CV death to statistical models based on traditional and nontraditional risk factors in ESRD patients. However, the risk estimate by CRP being reasonably close to that of IL-6, CRP may be a cheap alternative to IL-6 in clinical practice. |
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Authors:
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Giovanni Tripepi; Francesca Mallamaci; Carmine Zoccali |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 16 Suppl 1 ISSN: 1046-6673 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-06-06 Completed Date: 2005-07-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: S83-8 Citation Subset: IM |
Affiliation:
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National Research Council and Institute of Biomedicine Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cardiovascular Diseases / diagnosis, mortality*, therapy Cause of Death* Cell Adhesion Molecules / blood* Cohort Studies Cytokines / blood* Disease Progression Female Follow-Up Studies Humans Inflammation Mediators / blood Kidney Failure, Chronic / blood*, diagnosis, mortality*, therapy Kidney Function Tests Male Middle Aged Multivariate Analysis Proportional Hazards Models Renal Dialysis / methods Sensitivity and Specificity Severity of Illness Index Survival Analysis |
| Chemical | |
Reg. No./Substance:
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0/Cell Adhesion Molecules; 0/Cytokines; 0/Inflammation Mediators |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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