Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Graduate School of Engineering, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan.
BMC Nephrol. 2019 Mar 1;20(1):74. doi: 10.1186/s12882-019-1265-6.
Exacerbated inflammatory response is considered one of the key elements of acute kidney injury (AKI). Interleukin-6 (IL-6) is an inflammatory cytokine that plays important roles in the inflammatory response and may be useful for predicting the clinical outcomes in patients with AKI. However, supporting evidence adapted to the current KDIGO criteria is lacking.
AKI patients admitted to the ICU between Jan 2011 and Dec 2015 were retrospectively screened. Patients were assigned to three groups by admission IL-6 tertiles. Associations between IL-6 on ICU admission and in-hospital 90-day mortality, short-term/long-term renal function were analyzed.
Patients (n = 646) were divided into low (1.5-150.2 pg/mL), middle (152.0-1168 pg/mL), and high (1189-2,346,310 pg/mL) IL-6 on ICU admission groups. Patients in the high IL-6 group had higher in-hospital 90-day mortality (low vs. middle vs. high, P = 0.0050), lower urine output (low vs. middle vs. high, P < 0.0001), and an increased probability of persistent of anuria for ≥12 h (low vs. middle vs. high, P < 0.0001) within 72 h after ICU admission. In contrast, the high IL-6 group had a lower incidence of persistent AKI at 90 days after the ICU admission in survivors (low vs. middle vs. high, P = 0.013).
Serum levels of IL-6 on ICU admission may predict short-term renal function and mortality in AKI patients and were associated with renal recovery in survivors.
加重的炎症反应被认为是急性肾损伤（AKI）的关键因素之一。白细胞介素 6（IL-6）是一种炎症细胞因子，在炎症反应中发挥重要作用，可能有助于预测 AKI 患者的临床结局。然而，缺乏适应当前 KDIGO 标准的证据。
回顾性筛选了 2011 年 1 月至 2015 年 12 月期间入住 ICU 的 AKI 患者。根据入院时的 IL-6 三分位数将患者分为三组。分析了 ICU 入院时的 IL-6 与住院 90 天死亡率、短期/长期肾功能之间的关系。
患者（n=646）分为低（1.5-150.2pg/ml）、中（152.0-1168pg/ml）和高（1189-2346310pg/ml）IL-6 组。高 IL-6 组患者住院 90 天死亡率较高（低 vs. 中 vs. 高，P=0.0050），尿量较少（低 vs. 中 vs. 高，P<0.0001），且 ICU 入院后 72 小时内持续无尿的可能性增加（低 vs. 中 vs. 高，P<0.0001）。相反，在幸存者中，高 IL-6 组在 ICU 入院后 90 天持续 AKI 的发生率较低（低 vs. 中 vs. 高，P=0.013）。
ICU 入院时的血清 IL-6 水平可能预测 AKI 患者的短期肾功能和死亡率，并与幸存者的肾功能恢复相关。
