Document Detail


Interleukin-6 is an independent predictor of mortality in patients starting dialysis treatment.
MedLine Citation:
PMID:  12198224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The mortality rate is high among end-stage renal disease (ESRD) patients, and recent evidence suggests that this may be linked to inflammation. The activity of interleukin-6 (IL-6) and its soluble receptor (sIL-6R) are markedly up-regulated in ESRD patients, and plasma IL-6 levels predict outcome in haemodialysis (HD) patients. However, it has not been established whether elevated plasma IL-6 also predicts outcome in ESRD patients treated by peritoneal dialysis (PD), and how it relates to the data on HD patients. The predictive power of sIL-6R levels on outcome is also unknown in this patient population. METHODS: To determine whether or not plasma IL-6 and sIL-6R predict patient survival, we studied 173 ESRD patients (62% males, 53+/-1 years of age) near the initiation of dialysis treatment (99 PD, 74 HD patients). The patients were followed for a mean period of 3.1+/-0.1 years (range 0.1-7.1 years) and were stratified at the start of dialysis treatment according to age, gender, presence of cardiovascular disease, malnutrition (determined by subjective global assessment), diabetes mellitus, and IL-6 and sIL-6R plasma levels. RESULTS: A significantly different (P<0.0001) mortality rate was observed in different groups when patients were divided into quartiles according to IL-6 levels. Furthermore, the same differences were observed, less notably however, for sIL-6R (P<0.05). When patients were stratified according to IL-6 quartiles and analysed separately according to the different initial treatment groups, a similar profile of survival was observed for PD (P<0.01) and HD (P<0.05) patients. In a Cox proportional hazard model adjusting for the impact of age, malnutrition, diabetes mellitus and male gender, log IL-6 values were independently associated with poor outcome (P<0.05). CONCLUSIONS: The present study demonstrates that the strong predictive value of elevated IL-6 levels for poor outcome in ESRD patients is similar in both HD and PD patients starting treatment.
Authors:
Roberto Pecoits-Filho; Peter Bárány; Bengt Lindholm; Olof Heimbürger; Peter Stenvinkel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  17     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-28     Completed Date:  2003-02-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1684-8     Citation Subset:  IM    
Affiliation:
Division of Renal Medicine, Department of Clinical Science, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden. roberto.pecoits-filho@klinvet.ki.se
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Female
Humans
Interleukin-6 / blood*
Kidney Failure, Chronic / immunology,  mortality,  therapy*
Male
Middle Aged
Peritoneal Dialysis / mortality*
Predictive Value of Tests
Proportional Hazards Models
Receptors, Interleukin-6 / blood
Renal Dialysis / mortality*
Survival Rate
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Interleukin-6; 0/Receptors, Interleukin-6

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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