title: Interleukin-6 is a better predictor of mortality as compared to C-reactive protein, homocysteine, pentosidine and advanced oxidation protein products in hemodialysis patients.
abstract: Inflammatory markers predict mortality in hemodialysis (HD) patients, whereas a possible association between oxidative stress (OS) markers and survival is less clear. We assessed the impact on all-cause mortality of baseline inflammatory [high-sensitivity C-reactive protein and interleukin-6 (IL-6)] and OS markers (advanced oxidation protein products, pentosidine, homocysteine) in 112 HD patients. We found no significant correlations between inflammatory and OS markers. During the 5.5 years of follow-up, 51 patients died. In a Kaplan-Meier analysis, the survival rate was reduced in patients with IL-6 higher than the median (IL-6 >4.2 pg/ml) (log- rank = 6.47; p = 0.01), in diabetics (log-rank = 12.26; p = 0.0005) and in older patients (log-rank = 11.22; p = 0.0008). Moreover, in Cox analysis only IL-6 and age were independently associated with mortality. We conclude that in this group of prevalent Brazilian HD patients, IL-6 was a better predictor of survival than other inflammatory and OS markers.
authors.affiliation: Evangelic Medical School, Paraná Catholic University (PUCPR), Paraná, Brazil.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Pachaly
authors.forename: Marcelo M
authors.initials: MM
authors.lastname: do Nascimento
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Suliman
authors.forename: Shirley Y
authors.initials: SY
authors.lastname: Hayashi
authors.forename: Miguel C
authors.initials: MC
authors.lastname: Riella
authors.forename: Roberto C
authors.initials: RC
authors.lastname: Manfro
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D017127:Glycation End Products, Advanced / Q000032:analysis; D006710:Homocysteine / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality*; D008239:Lysine / Q000031:analogs & derivatives / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D011379:Prognosis; D011506:Proteins / Q000378:metabolism; D006435:Renal Dialysis / Q000401:mortality; D015996:Survival Rate
chemical_list: D017127:Glycation End Products, Advanced; D015850:Interleukin-6; D011506:Proteins; D006710:Homocysteine; D002097:C-Reactive Protein; D001120:Arginine; C062187:pentosidine; D008239:Lysine