Impact of a genetic polymorphism of the interleukin-1 receptor antagonist on technique survival in peritoneal dialysis patients.
OBJECTIVE
There is a clear association between one allele of the interleukin-1 receptor-antagonist gene (IL-1RN) and inflammatory diseases in which IL-1 is implicated. We evaluated patient survival and technique survival of peritoneal dialysis (PD) patients, while analyzing independent risk factors, in a PD program. We also tested the association between IL-1RN polymorphism, patient survival and technique survival.


METHODS
We retrospectively evaluated 129 Japanese CAPD patients undergoing initial treatment in eight centers in Japan. Using PCR, IL-1RN genotype and allele frequencies were determined, and clinical and biochemical variables were recorded at the start of PD. The relation of patient survival or technique survival with IL-1RN polymorphism and those variables was analyzed with a multivariate Cox's proportional-hazard model.


RESULTS
The frequencies of IL-1RN*1/IL-1RN*1 and IL-1RN*1/IL-1RN*2 genotypes were 84.5 and 15.5%, respectively. Median patient survival was 37.0 months, and overall patient survival was 92.8 and 87.9% at 2 and 5 years, respectively. Age, cardiovascular disease and serum albumin were found to be independent predictors of patient survival. Median technique survival was 32 months. PD failure occurred in 37 patients, with technique survival rates of 92.0 and 72.7% at 2 and 5 years, respectively. Serum albumin, peritonitis and the presence of the IL-1RN*2 genotype were found to be independent predictors of technique survival.


CONCLUSIONS
Serum albumin was the strongest predictive factor for mortality and technique failure in PD. Technique failure was also affected by IL-1RN polymorphism in this patient population.
Uchiyama
Koichi
K
Department of Urology, Yamaguchi University School of Medicine, Yamaguchi, Japan.
Naito
Katsusuke
K
Tsuchida
Masahiro
M
Takai
Kimio
K
Okayama
Naoko
N
Fujimura
Kozue
K
Hinoda
Yuji
Y
D000328:Adult; D000483:Alleles; D002318:Cardiovascular Diseases / Q000150:complications / Q000235:genetics / Q000401:mortality; D005260:Female; D005787:Gene Frequency; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality; D010538:Peritonitis / Q000209:etiology / Q000235:genetics / Q000401:mortality; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D051437:Renal Insufficiency / Q000150:complications / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D012795:Sialoglycoproteins
C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D012795:Sialoglycoproteins