title: IL-1β receptor antagonist reduces inflammation in hemodialysis patients.
abstract: Chronic inflammation is highly prevalent in maintenance hemodialysis (MHD) patients and associates with increased mortality. IL-1β, a pro-inflammatory cytokine, is elevated in MHD patients. A balance between IL-1β and its naturally occurring antagonist may determine the inflammatory response and its consequences in this population. We performed a pilot randomized placebo-controlled trial to evaluate the efficacy of the administration of recombinant human IL-1 receptor antagonist (IL-1ra) on biomarkers of inflammation and nutrition in MHD patients with three consecutive high sensitivity C-reactive protein (hsCRP) measurements >5 mg/L. We randomly assigned 22 patients to placebo or IL-1ra (1:1) for 4 weeks; 14 completed the trial. Patients in the IL-1ra arm had a 53% reduction in mean hsCRP compared with 1% in the placebo arm (P = 0.008), a 40% reduction in mean IL-6 levels compared with a 20% increase in the placebo arm (P = 0.03), and a 23% increase in mean prealbumin compared with 6% in the placebo arm (P = NS). In conclusion, the administration of IL-1ra in MHD patients can lower biomarkers of inflammation. Whether IL-1ra administration improves survival in this population requires additional long-term studies.
authors.affiliation: Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Avenue South & Garland, Nashville, TN 37232-2372, USA.
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Hung
authors.forename: Charles D
authors.initials: CD
authors.lastname: Ellis
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.forename: Cindy
authors.initials: C
authors.lastname: Booker
authors.forename: T Alp
authors.initials: TA
authors.lastname: Ikizler
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017472:Receptors, Interleukin-1 / Q000037:antagonists & inhibitors*; D006435:Renal Dialysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D015850:Interleukin-6; D017472:Receptors, Interleukin-1; D002097:C-Reactive Protein