Dorota Sikorska1, Krzysztof Pawlaczyk2, Magdalena Roszak3, Natasza Czepulis3, Andrzej Oko2, Marek Karczewski4, Andrzej Breborowicz3, Janusz Witowski5. 1. Department of Pathophysiology, Poznan University of Medical Sciences, Poland; Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland. 2. Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, Poland. 3. Department of Pathophysiology, Poznan University of Medical Sciences, Poland. 4. Department of Transplantology, General, Vascular and Plastic Surgery, Poznan University of Medical Sciences, Poland. 5. Department of Pathophysiology, Poznan University of Medical Sciences, Poland. Electronic address: jwitow@ump.edu.pl.
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.
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 PDpatients in terms of their fluid status and cardiac parameters. METHODS: Fifty-seven prevalent PDpatients 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 PDpatients 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.
Authors: M Miler; N Nikolac; D Segulja; S Kackov Maslac; I Celap; K Altabas; S Sefer; A M Simundic Journal: J Endocrinol Invest Date: 2016-09-06 Impact factor: 4.256