Hasuike Yukiko, Nonoguchi Hiroshi, Ito Katsukiyo, Naka Miki, Kitamura Rie, Nanami Masayoshi, Tokuyama Masanori, Kida Aritoshi, Otaki Yoshinaga, Kuragano Takahiro, Nakanishi Takeshi
Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan.
Am J Nephrol. 2009;30(4):389-98. doi: 10.1159/000235687. Epub 2009 Aug 19.
BACKGROUND/AIMS: Mortality in end-stage renal disease patients with dialysis remains high. A high percentage of dialysis patients display signs of chronic microinflammation. To clarify whether microinflammation is involved in the high incidence of poor prognosis in dialysis patients, we investigated the association of inflammatory markers with mortality in a prospective observational cohort study.
120 patients undergoing hemodialysis were enrolled. Baseline cross-sectional analysis of the relationship between inflammatory markers [interleukin-6 (IL-6), tumor necrosis factor-alpha and high-sensitivity C-reactive protein] and other factors, along with a survival analysis for death, were performed. All subjects were divided into 2 groups according to the median value of IL-6.
The mortality rate was significantly higher in the high (20.0%) compared with the low IL-6 group (3.3%, p = 0.0046). Receiver-operating characteristic curves indicated high mortality to be closely associated with a high IL-6 level rather than tumor necrosis factor-alpha. In stepwise multiple regression analyses, age, phosphorus and high-sensitivity C-reactive protein were independent predictors of IL-6 (R(2) = 0.466, p < 0.0001).
These data clearly show that plasma IL-6 is a powerful predictor of all-cause mortality in dialysis patients.
背景/目的：接受透析的终末期肾病患者死亡率仍然很高。高比例的透析患者表现出慢性微炎症迹象。为了阐明微炎症是否与透析患者预后不良的高发生率有关，我们在一项前瞻性观察队列研究中调查了炎症标志物与死亡率之间的关联。
纳入120例接受血液透析的患者。对炎症标志物[白细胞介素-6（IL-6）、肿瘤坏死因子-α和高敏C反应蛋白]与其他因素之间的关系进行基线横断面分析，并对死亡进行生存分析。所有受试者根据IL-6的中位数分为两组。
高IL-6组的死亡率（20.0%）显著高于低IL-6组（3.3%，p = 0.0046）。受试者工作特征曲线表明高死亡率与高IL-6水平密切相关，而非肿瘤坏死因子-α。在逐步多元回归分析中，年龄、磷和高敏C反应蛋白是IL-6的独立预测因素（R² = 0.466，p < 0.0001）。
这些数据清楚地表明，血浆IL-6是透析患者全因死亡率的有力预测指标。
