Interleukin-18 is a strong predictor of hospitalization in haemodialysis patients
Interleukin-18 is a strong predictor of hospitalization in haemodialysis patients
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DOI：
10.1093/ndt/gfh475
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发表时间：
2004-11-01
影响因子：
6.1
通讯作者：
Tsai, TJ
中科院分区：
文献类型：
--
作者：
Chiang, CK;Hsu, SP;Tsai, TJ
背景。终末期肾病 (ESRD) 患者的发病率和死亡率很高，最近的证据表明这可能与炎症有关。目前的研究还证明了白细胞介素 18 (IL-18) 在炎症中的重要作用。一致认为，ESRD 患者中 IL-18 的活性显着上调。然而，尚未确定血浆 IL-18 升高是否可以预测血液透析 (HD) 患者的结果。方法。为了确定血浆 IL-18 是否可以预测总体住院情况，我们研究了 184 名接受 HD 维持治疗的 ESRD 患者（62% 为男性，58.5 +/- 1.0 岁）。对患者进行 12 个月的随访，并根据血浆 IL-18 水平的三分位数进行分层。 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.采用Kaplan-Meier法分析无住院事件的累积比例。结果。 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.在 Kaplan-Meier 模型中，IL-18 的上三分位数在整个随访期间发生住院事件的概率最高（P 对数秩 = 0.027）。在 Cox 比例风险模型中，Ln IL-18 (pg/ml) 浓度每增加一次，首次入院的相对风险与未来住院事件风险增加 1.709（95% CI，1.114 至 2.620；P = 0.014）相关。结论。本研究表明，IL-18 水平升高对 HD 患者预后不良具有很强的预测价值。
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.