Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients
| Autor: | Thomas S. Parker, Kurt H. Stenzel, David Serur, Daniel M. Levine, RM Bologa, Jhoong S. Cheigh, Albert L. Rubin |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Malnutrition–inflammation complex Adolescent medicine.medical_treatment Serum albumin Gastroenterology Liver disease Predictive Value of Tests Renal Dialysis Risk Factors Internal medicine medicine Humans Prospective Studies Hypoalbuminemia Prospective cohort study Serum Albumin Aged Aged 80 and over biology Interleukin-6 Tumor Necrosis Factor-alpha business.industry Middle Aged medicine.disease Surgery Hypocholesterolemia Cholesterol Nephrology biology.protein Kidney Failure Chronic Female Hemodialysis business Kidney disease |
| Zdroj: | American Journal of Kidney Diseases. 32:107-114 |
| ISSN: | 0272-6386 |
| DOI: | 10.1053/ajkd.1998.v32.pm9669431 |
| Popis: | Low serum albumin and low serum cholesterol levels are among the most consistent predictors of mortality in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Hypoalbuminemia is often interpreted as a marker of poor nutrition, but serum albumin and cholesterol levels can also be low as part of a cytokine-mediated acute-phase reaction to acute or chronic inflammation. Here we report the results from a 900-day prospective study designed to determine whether tumor necrosis factor-alfa (TNF-alpha) and interleukin-6 (IL-6) predict serum albumin and cholesterol levels and mortality in a group of 90 ambulatory, adult hemodialysis patients with no acute infection, hospitalization or surgery, and no known acquired immunodeficiency syndrome (AIDS), malignancy, or liver disease. Measurable levels of TNF-alpha and/or IL-6 were found in 89 of 90 patients. Significant relationships were found between TNF-alpha and IL-6 and the degree of hypoalbuminemia and dyslipoproteinemia. IL-6 was the strongest predictor of mortality in univariate and multivariate analysis, followed by age, albumin level, and body mass index (BMI). Although the cause of hypercytokinemia was not addressed in this study, the data support the view that hypoalbuminemia and hypocholesterolemia are negative acute-phase responses to inflammatory stimuli. These results suggest that efforts to identify the nature of the stimuli for cytokine production and to lower cytokine levels in hemodialysis patients might be effective in improving the survival of patients undergoing hemodialysis. |
| Databáze: | OpenAIRE |
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