Baseline serum interleukin-6 predicts cardiovascular events in incident peritoneal dialysis patients.
BACKGROUND
The utility of local and systemic interleukin 6 (IL-6) as a prognostic marker in incident peritoneal dialysis (PD) patients remains to be fully defined. The present study aimed to explore the capacity of systemic IL-6 concentrations to predict cardiovascular events (CVEs) and mortality in PD patients, and to evaluate the influence of neutral-pH PD solutions low in glucose degradation products (GDPs) on systemic IL-6.


METHODS
The study included 175 incident participants from the balANZ trial with at least one stored serum sample. A composite CVE score was used as the primary clinical outcome measure. Multilevel linear regression and Poisson regression models were fitted to describe, respectively, the trend of serum IL-6 over time and its ability to predict composite CVE.


RESULTS
A significant increase in serum IL-6 from baseline to 24 months was observed in the study population (mean difference: 1.68 pg/mL; p = 0.006). The type of PD solution received by patients exerted no significant effect on serum IL-6 (p = 0.12). Composite CVE was significantly and independently associated with baseline serum IL-6 (incidence rate ratio per picogram per milliliter: 1.06; 95% confidence interval: 1.02 to 1.10; p = 0.003).


CONCLUSIONS
Baseline serum IL-6 was a significant independent predictor of composite CVE. Serum IL-6 concentrations increased with increasing PD duration and were not significantly modified with the use of biocompatible fluid over the study period. The present study is the first to link systemic IL-6 concentrations with CVE outcomes in incident PD patients.
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
Yeoungjee
Y
Cho
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
David W
DW
Johnson
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
David A
DA
Vesey
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
Carmel M
CM
Hawley
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
Elaine M
EM
Pascoe
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
Margaret
M
Clarke
Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Fresenius Medical Care, Sydney, Australia; Institute of Translation, Innovation, Methodology and Engagement, Cardiff University School of Medicine, Cardiff, UK.
Nicholas
N
Topley
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
D015415:Biomarkers; D015850:Interleukin-6
Biocompatibility; cardiovascular events; glucose degradation products; interleukin 6; mortality