IL6 plasma concentrations in patients with sepsis receiving SLED and antibiotics: a predictor for survival.
BACKGROUND
The present study evaluated interleukin-6 (IL6) as a predictor of mortality in patients and sepsis with acute kidney injury (AKI) receiving sustained low-efficiency dialysis (SLED) and antibiotic therapy.


METHODS
Seven patients with sepsis receiving antibiotics and SLED for AKI were studied. Blood was obtained at baseline prior to SLED and antibiotics, during SLED, and then after stopping SLED. IL6 concentrations were measured using an enzyme-linked immunosorbent assay (ELISA).


RESULTS
Mean plasma IL6 concentrations ranged between 700 and 900 pg/ml for the first 8 h after starting SLED but was significantly lower after discontinuation of SLED (200-250 pg/ml) (p=0.0044). Three out of seven patients survived to be discharged from the hospital and all three had significantly lower concentrations of IL6 during the first 8 h compared to those who died in the hospital (p<0.0001).


CONCLUSIONS
The combination of SLED and antibiotic therapy was unable to lower the initial high plasma IL6 concentrations, and high initial IL6 concentrations predicted in-hospital mortality.
Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, U.S.A. trmcguir@unmc.edu.
Timothy R
TR
McGuire
Pharmacy Department, Ocala Regional Medical Center, Ocala, FL, U.S.A.
Nicole T
NT
Reardon
Department of Pharmaceutical Services and Nutrition Care, The Nebraska Medical Center, Omaha, NE, U.S.A.
Kimberly
K
Bogard
Division of Nephrology, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, U.S.A.
Troy J
TJ
Plumb
Department of Pharmaceutical Services and Nutrition Care, The Nebraska Medical Center, Omaha, NE, U.S.A.
Chris J
CJ
Bultsma
Department of Pharmaceutical Services and Nutrition Care, The Nebraska Medical Center, Omaha, NE, U.S.A.
Steve W
SW
Nissen
Department of Pharmaceutical Services and Nutrition Care, The Nebraska Medical Center, Omaha, NE, U.S.A.
Patrick D
PD
Fuller
Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, U.S.A.
Keith M
KM
Olsen
D058186:Acute Kidney Injury / Q000097:blood* / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D018805:Sepsis / Q000097:blood* / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D015850:Interleukin-6
IL6; SLED; Sepsis; survival