Interleukin-18 is a strong predictor of hospitalization in haemodialysis patients
Journal
Nephrology Dialysis Transplantation
Journal Volume
19
Journal Issue
11
Pages
2810-2815
Date Issued
2004
Author(s)
Abstract
Background. Morbidity and mortality rates are high among patients with end-stage renal disease (ESRD), and recent evidence suggests that this may be linked to inflammation. Current research has also demonstrated the crucial involvement of interleukin-18 (IL-18) in inflammation. In agreement, the activity of IL-18 has been markedly up-regulated in ESRD patients. However, it has not been established whether elevated plasma IL-18 predicts outcome in haemodialysis (HD) patients. Methods. To determine whether plasma IL-18 predicts overall hospitalization, we studied 184 ESRD patients (62% males, 58.5 ± 1.0 years of age) undergoing maintenance HD treatment. The patients were followed for 12 months and were stratified by the tertiles of plasma IL-18 levels. Classic factors, such as age, body mass index, duration of HD, nutritional and inflammatory parameters, co-morbidity, dialysis adequacy, and lipid status were entered into a Cox regression model to predict hospitalization. The Kaplan-Meier method was used to analyse the cumulative proportion of hospitalization-free events. Results. Significantly different hospitalization days and frequencies (P < 0.05) were observed when patients were divided according to tertiles of plasma IL-18 levels. Patients were stratified according to IL-18 tertiles and analysed separately according to the hospitalization-free period. In the Kaplan-Meier model, the upper tertile of IL-18 had the highest probability of a hospitalization event during the entire follow-up period (P log rank = 0.027). In the Cox proportional hazard model, the relative risk for first hospital admission for each increase in Ln IL-18 (pg/ml) concentration was associated with a 1.709 (95% CI, 1.114 to 2.620; P = 0.014) increase in the risk for future hospitalization events. Conclusions. The present study demonstrated a strong predictive value of elevated IL-18 levels for poor outcome in HD patients. ? ERA-EDTA 2004; all rights reserved.
SDGs
Other Subjects
interleukin 18; lipid; adult; article; body mass; clinical observation; comorbidity; confidence interval; controlled study; female; follow up; hemodialysis patient; hospital admission; hospitalization; human; inflammation; Kaplan Meier method; kidney failure; lipid blood level; maintenance therapy; major clinical study; male; nutritional status; prediction; priority journal; probability; protein blood level; regression analysis; risk assessment; statistical significance; treatment outcome; upregulation; Comorbidity; Female; Hospitalization; Humans; Interleukin-18; Kidney Failure, Chronic; Male; Middle Aged; Multivariate Analysis; Prognosis; Proportional Hazards Models; Retrospective Studies
Type
journal article