Interleukin-6 is a predictor of mortality in stable hemodialysis patients.
OBJECTIVE
Mortality in end-stage renal disease patients with dialysis remains high. A high percentage of dialysis patients display signs of chronic microinflammation. To clarify whether microinflammation is involved in the high incidence of poor prognosis in dialysis patients, we investigated the association of inflammatory markers with mortality in a prospective observational cohort study.


METHODS
120 patients undergoing hemodialysis were enrolled. Baseline cross-sectional analysis of the relationship between inflammatory markers [interleukin-6 (IL-6), tumor necrosis factor-alpha and high-sensitivity C-reactive protein] and other factors, along with a survival analysis for death, were performed. All subjects were divided into 2 groups according to the median value of IL-6.


RESULTS
The mortality rate was significantly higher in the high (20.0%) compared with the low IL-6 group (3.3%, p = 0.0046). Receiver-operating characteristic curves indicated high mortality to be closely associated with a high IL-6 level rather than tumor necrosis factor-alpha. In stepwise multiple regression analyses, age, phosphorus and high-sensitivity C-reactive protein were independent predictors of IL-6 (R(2) = 0.466, p < 0.0001).


CONCLUSIONS
These data clearly show that plasma IL-6 is a powerful predictor of all-cause mortality in dialysis patients.
Hasuike
Yukiko
Y
Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan. cherry39@hyo-med.ac.jp
Nonoguchi
Hiroshi
H
Ito
Katsukiyo
K
Naka
Miki
M
Kitamura
Rie
R
Nanami
Masayoshi
M
Tokuyama
Masanori
M
Kida
Aritoshi
A
Otaki
Yoshinaga
Y
Kuragano
Takahiro
T
Nakanishi
Takeshi
T
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha