Predictive value of interleukins 6, 8 and 10, and low HLA-DR expression in acute renal failure.
OBJECTIVE
HLA-DR expression and plasma levels of pro- and anti-inflammatory cytokines (IL-6, IL-8 and IL-10) and their predictive value concerning survival of critically ill systemic inflammatory response syndrome (SIRS) patients with and without acute renal failure (ARF) were evaluated.


METHODS
A total of 103 consecutive adult patients with SIRS from 2 university hospital intensive care units participated in the study.


METHODS
Laboratory data for all patients were prospectively collected on the day of admission and 2 days thereafter. Patients with acute renal failure (ARF) and non-ARF patients were compared by Mann-Whitney U-test. Independent predictors of mortality were tested using forward stepwise logistic multiple regression analysis. The discriminative power of different variables was tested using receiver operating characteristic (ROC) curve analysis.


RESULTS
ARF developed in 36 patients (35%). ARF patients showed significantly lower HLA-DR expression and higher plasma levels of IL-6, IL-8 and IL-10 than non-ARF patients. In ARF, moderate discriminative power in predicting survival was observed for day 2 IL-6 and IL-10 plasma levels (AUCs 0.703 and 0.749, respectively).


CONCLUSIONS
We found no clinically significant discriminative power in predicting survival of ARF patients for monocyte HLA-DR expression or cytokine plasma levels. Therefore, our results do not support the use of HLA-DR expression or cytokine plasma levels for that purpose.
Department of Surgery, Division of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. annika.ahlstrom@hus.fi
A
A
Ahlström
M
M
Hynninen
M
M
Tallgren
P
P
Kuusela
M
M
Valtonen
R
R
Orko
S
S
Siitonen
O
O
Takkunen
V
V
Pettilä
D058186:Acute Kidney Injury / Q000209:etiology / Q000378:metabolism* / Q000401:mortality*; D000328:Adult; D005260:Female; D006684:HLA-DR Antigens / Q000378:metabolism*; D006801:Humans; D007378:Interleukins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000378:metabolism / Q000401:mortality
D006684:HLA-DR Antigens; D007378:Interleukins