Preliminary observations on the association between serum IL-6 and hydration status and cardiovascular risk in patients treated with peritoneal dialysis. (September 2016)

• Record Type: Journal Article
• Authors: Sikorska, Dorota; Pawlaczyk, Krzysztof; Roszak, Magdalena; Czepulis, Natasza; Oko, Andrzej; Karczewski, Marek; Breborowicz, Andrzej; Witowski, Janusz
• Is Part Of: Cytokine. Volume 85(2016)
• Page Start: 171
• Page End: 176
• Publication Date: 2016-09
• Subjects: IL-6 -- Overhydration -- Cardiovascular risk; Cytokines -- Periodicals; 571.844
• DOI: 10.1016/j.cyto.2016.06.005
• Languages: English
• ISSNs: 1043-4666

Abstract

Highlights: Peritoneal dialysis patients stratified according to serum IL-6 are characterized. Association of high serum IL-6 with overhydration and hypoalbuminemia is documented. Patients with high IL-6 have increased levels of cardiac NT-proBNP and troponin. High systemic IL-6 identifies dialyzed patients with increased cardiovascular risk. Abstract: Introduction: Systemic inflammation, as defined by elevated blood IL-6, is a strong independent predictor of peritoneal dialysis (PD) patient survival. The present study has aimed to determine whether there exists a particular "phenotype" associated with high systemic IL-6 that characterizes PD patients in terms of their fluid status and cardiac parameters. Methods: Fifty-seven prevalent PD patients were classified according to serum concentrations of IL-6. The degree of overhydration was assessed by bioimpedance analysis (BIA). Echocardiography and serum concentrations of NT-proBNP and troponin T were used to assess cardiovascular risk. Results: Patients with high serum IL-6 were older, more often diabetic, treated with PD for longer, and significantly more overhydrated. There was a significant correlation between serum IL-6, hydration status (r = 0.38; p = 0.002) and serum albumin (r = −0.35; p = 0.009). Multivariate regression analysis confirmed a strong association of overhydration, hypoalbuminemia, and systemic IL-6 concentration. Patients with high IL-6 had significantly increased levels of both NT-proBNP (r = 0.36; p = 0.006) and TnT (r = 0.50; p < 0.001) in the absence of abnormalities in echocardiography. Conclusions: High systemic IL-6 identifies PD patients with increased cardiovascular risk that is significantly related to overhydration. Thus, the measurement of serum IL-6 may contribute to the more accurate assessment of cardiovascular status in patients undergoing PD.