Interleukin-8 is a powerful prognostic predictor of all-cause and cardiovascular mortality in dialytic patients.
BACKGROUND
Cohort studies have demonstrated an association between C-reactive protein (CRP) and interleukin-6 (IL-6) and all-cause and cardiovascular mortality in end-stage renal disease (ESRD) patients. Interleukin-8 (IL-8) appears to be not only the plasma expression of the acute-phase response but also a direct pathogenetic mediator of the atherosclerotic process.


METHODS
To evaluate the role of IL-8 in predicting outcome, 76 chronic dialytic patients were prospectively followed for 18 months. At baseline, blood samples were taken for analysis of high-sensitivity CRP, IL-6, IL-8 and other standard laboratory analyses.


RESULTS
Median IL-8 was 5.2 mg/l, therefore near half of the patients had IL-8 values within the range of 'normal limits'. IL-6 and CRP were significantly correlated (r = 0.45, p < 0.001) and a positive correlation was also found between IL-6 and IL-8 (r = 0.39, p < 0.001). The correlation coefficient between IL-6 and CRP was 0.43 (p < 0.001) and 0.50 (p < 0.001) in patients without and with history and/or clinical signs of cardiovascular disease, respectively. After a follow-up of 1.5 years, 8 patients had died from cardiovascular causes and another 7 patients for other reasons; furthermore 9 major nonfatal cardiovascular events were recorded. Stepwise regression analysis showed IL-8 as the strongest independent predictor of all-cause and cardiovascular events (p = 0.0025) even after adjustment for age and dialytic age, followed by IL-6 and CRP (p < 0.01).


CONCLUSIONS
Despite a small population and a relatively short follow-up period, this study firstly demonstrated that IL-8 is a powerful independent predictive factor for cardiovascular and overall mortality cause in ESRD patients.
Panichi
Vincenzo
V
Internal Medicine, University of Pisa, Pisa, Italy. vpanichi@med.unipi.it
Taccola
Daniele
D
Rizza
Giovanni Manca
GM
Consani
Cristina
C
Ghiadoni
Lorenzo
L
Filippi
Cristina
C
Cristofani
Renza
R
Panicucci
Erica
E
Migliori
Massimiliano
M
Sidoti
Antonino
A
Biagioli
Marina
M
Boracelli
Donella
D
Barsotti
Giuliano
G
Tetta
Ciro
C
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D015996:Survival Rate
D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D002097:C-Reactive Protein