Military Hospital 103, Hanoi, Vietnam.
An Sinh Hospital, Ho Chi Minh, Vietnam.
Int Urol Nephrol. 2020 Jun;52(6):1135-1142. doi: 10.1007/s11255-020-02461-7. Epub 2020 Apr 18.
In this study, we focused on the role of elevated serum interleukin 6 (IL-6) concentration in predicting 5-year cardiovascular mortality in hemodialysis patients using low-flux dialyzer reuse.
We measured serum IL-6 concentrations in 236 hemodialysis patients (138 males and 98 females) to predict 5-year cardiovascular mortality. We assessed the baseline demographics of all patients who had a mean age of 44 years and a median hemodialysis duration of 38.5 months. We divided all patients into two equal groups based on the serum IL-6 concentration: G1 (n = 118) with serum IL-6 concentration < 6.78 pg/L and G2 (n = 118) with serum IL-6 concentration ≥ 6.78 pg/L.
After the 5-year follow-up, 45 patients died due to cardiovascular causes (19.1%). Lipid disorder, hemoglobin, serum albumin, β2-M, and IL-6 concentration were independent risk factors for predicting cardiovascular mortality during the 60-month follow-up in hemodialysis patients. Based on the Kaplan-Meier analysis, we realized that patients with a higher interleukin 6 concentration (G2) had a significantly higher cardiovascular mortality rate than patients in G1 (log-rank test p < 0.001). Serum IL-6 concentration was a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in hemodialysis patients using low-flux dialyzer reuse (AUC = 0.818; p < 0.001; cut-off value: 8.055 pg/mL, Se = 77.8%, Sp = 78.5%).
Serum IL-6 concentration was a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in maintenance hemodialysis patients using low-flux dialysis reuse.
在本研究中,我们专注于使用低通量透析器复用的情况下,血清白细胞介素 6(IL-6)浓度升高在预测血液透析患者 5 年心血管死亡率中的作用。
我们测量了 236 名血液透析患者(138 名男性和 98 名女性)的血清 IL-6 浓度,以预测 5 年心血管死亡率。我们评估了所有患者的基线人口统计学特征,这些患者的平均年龄为 44 岁,中位数血液透析时间为 38.5 个月。我们根据血清 IL-6 浓度将所有患者分为两组:G1 组(n=118)血清 IL-6 浓度<6.78pg/L,G2 组(n=118)血清 IL-6 浓度≥6.78pg/L。
经过 5 年的随访,有 45 名患者因心血管原因死亡(19.1%)。在血液透析患者的 60 个月随访中,血脂异常、血红蛋白、血清白蛋白、β2-M 和 IL-6 浓度是预测心血管死亡率的独立危险因素。根据 Kaplan-Meier 分析,我们发现 IL-6 浓度较高的患者(G2)的心血管死亡率明显高于 G1 组(对数秩检验,p<0.001)。在使用低通量透析器复用的血液透析患者中,血清 IL-6 浓度比高敏 C 反应蛋白更能预测 5 年心血管死亡率(AUC=0.818;p<0.001;截断值:8.055pg/ml,Se=77.8%,Sp=78.5%)。
在使用低通量透析器复用的维持性血液透析患者中,血清 IL-6 浓度比高敏 C 反应蛋白更能预测 5 年心血管死亡率。