title: The -174G/C variant of IL6 as risk factor for mortality and technique failure in a large cohort of peritoneal dialysis patients.
abstract: BACKGROUND
  Functional variants in the IL6 gene, in particular the -174G/C polymorphism (rs1800795), affect the mortality risk in dialysis patients. Peritoneal dialysis (PD) patients harbouring the C allele of the -174G/C polymorphism of IL6 showed faster peritoneal transport. The aim of this study was to investigate this IL6 variant as risk factor for mortality and technique failure in a large cohort of Caucasian PD patients.
  
  
  METHODS
  A Dutch multicentre cohort of 398 incident PD patients (NECOSAD) was analysed. Survival analysis was performed for death and technique failure with a maximum follow-up of 5 years. A combined PD cohort from Amsterdam (Academic Medical Center, N = 71) and Brussels (Université catholique de Louvain Medical School, N = 102) was used for independent replication.
  
  
  RESULTS
  In NECOSAD, 105 patients died on dialysis [incidence rate 10.3/100 person-years (py)], and 138 patients experienced technique failure (16.2/100 py), with peritonitis as important cause. Patients with the C/C genotype had a 71% increased mortality risk compared to patients with the G/G genotype (95% confidence interval 0.98-2.98); this effect was mainly a long-term effect: a 2.7-fold increased mortality risk was found in patients having survived 2 years since the start on dialysis, and a 1.7-fold increased risk for the combined end point (mortality or technique failure). In the combined replication cohort, no increased risks were found in patients with the C/C genotype.
  
  
  CONCLUSIONS
  The C/C genotype of the -174G/C polymorphism was associated with an increased mortality risk in 398 Dutch incident PD patients. The existence of substantial differences between the two academic replication cohorts and the discovery cohort from NECOSAD and the limited power of these cohorts prevented an independent replication of the NECOSAD findings.
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. m.verduijn@lumc.nl
authors.forename: Marion
authors.initials: M
authors.lastname: Verduijn
authors.forename: Céline
authors.initials: C
authors.lastname: Maréchal
authors.forename: Annemieke M
authors.initials: AM
authors.lastname: Coester
authors.forename: Denise E
authors.initials: DE
authors.lastname: Sampimon
authors.forename: Els W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.forename: Eric
authors.initials: E
authors.lastname: Goffin
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Krediet
authors.forename: Olivier
authors.initials: O
authors.lastname: Devuyst
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D005919:Glomerular Filtration Rate; D006801:Humans; D015850:Interleukin-6 / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000401:mortality*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic / Q000235:genetics*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000235:genetics / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate; D017211:Treatment Failure
chemical_list: D015850:Interleukin-6