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Baseline serum interleukin-6 predicts cardiovascular events in incident peritoneal dialysis patients
Yeoungjee Cho1, David W Johnson1, David A Vesey1
1Department 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.
Insights
Baseline serum interleukin 6 (IL-6) predicts cardiovascular events in peritoneal dialysis (PD) patients. Serum IL-6 levels increase over time but are unaffected by biocompatible PD solutions.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- The prognostic value of interleukin 6 (IL-6) in incident peritoneal dialysis (PD) patients requires further clarification.
- Systemic IL-6's role in predicting cardiovascular events (CVEs) and mortality in PD patients is under investigation.
- The impact of neutral-pH PD solutions with low glucose degradation products (GDPs) on systemic IL-6 needs evaluation.
Purpose of the Study:
- To determine if systemic IL-6 concentrations can predict CVEs and mortality in incident PD patients.
- To assess the influence of modern, biocompatible PD solutions on systemic IL-6 levels.
- To establish the relationship between baseline IL-6 and long-term clinical outcomes in PD.
Main Methods:
- Analysis of serum samples from 175 incident PD patients in the balANZ trial.
- Utilized a composite CVE score as the primary clinical outcome.
- Employed multilevel linear and Poisson regression models to analyze IL-6 trends and predictive capacity.
Main Results:
- Serum IL-6 significantly increased from baseline to 24 months (mean difference: 1.68 pg/mL; p = 0.006).
- PD solution type did not significantly affect serum IL-6 levels (p = 0.12).
- Baseline serum IL-6 independently predicted composite CVE (IRR: 1.06; 95% CI: 1.02-1.10; p = 0.003).
Conclusions:
- Baseline serum IL-6 is a significant independent predictor of composite CVE in incident PD patients.
- Serum IL-6 concentrations rise with PD duration but are not altered by biocompatible fluids.
- This study is the first to connect systemic IL-6 levels with CVE outcomes in incident PD 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.
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