High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study
IntroductionUF insufficiency is a major limitation in PD efficiency and sustainability. Our study object to investigate the efficacy of intraperitoneal inflammation marker, IL-6 level as a predictor of UF insufficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsStable preval...
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Frontiers Media S.A.
2022-08-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.836861/full |
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| author | Qianhui Song Qianhui Song Xiaoxiao Yang Xiaoxiao Yang Yuanyuan Shi Yuanyuan Shi Hao Yan Hao Yan Zanzhe Yu Zanzhe Yu Zhenyuan Li Zhenyuan Li Jiangzi Yuan Jiangzi Yuan Zhaohui Ni Zhaohui Ni Leyi Gu Leyi Gu Wei Fang Wei Fang |
| author_facet | Qianhui Song Qianhui Song Xiaoxiao Yang Xiaoxiao Yang Yuanyuan Shi Yuanyuan Shi Hao Yan Hao Yan Zanzhe Yu Zanzhe Yu Zhenyuan Li Zhenyuan Li Jiangzi Yuan Jiangzi Yuan Zhaohui Ni Zhaohui Ni Leyi Gu Leyi Gu Wei Fang Wei Fang |
| author_sort | Qianhui Song |
| collection | DOAJ |
| description | IntroductionUF insufficiency is a major limitation in PD efficiency and sustainability. Our study object to investigate the efficacy of intraperitoneal inflammation marker, IL-6 level as a predictor of UF insufficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsStable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6 AR). Patients were divided into two groups according to the median of IL-6 AR and prospectively followed up until death, transfer to permanent HD, recovery of renal function, kidney transplantation, transfer to other centers, lost to follow-up or to the end of study (January 31, 2021). Factors associated with UF capacity as well as dialysate IL-6 AR were assessed by multivariable linear regression. Cox proportional hazards model was used to examine the association between dialysate IL-6 AR and UF insufficiency.ResultsA total of 291 PD patients were enrolled, including 148 males (51%) with a mean age of 56.6 ± 14.1 years and a median PD duration of 33.4 (12.7–57.5) months. No correlation was found between dialysate IL-6 AR and UF capacity at baseline. PD duration was found positively correlated with baseline dialysate IL-6 AR, while 24h urine volume was negatively correlated with baseline dialysate IL-6 AR (P < 0.05). By the end of study, UF insufficiency was observed in 56 (19.2%) patients. Patients in the high IL-6 AR group showed a significantly inferior UF insufficiency-free survival when compared with their counterparts in the low IL-6 AR group (P = 0.001). In the multivariate Cox regression analysis, after adjusting for DM, previous peritonitis episode and 24h urine volume, higher baseline dialysate IL-6 AR (HR 3.639, 95% CI 1.776–7.456, P = 0.002) were associated with an increased risk of UF insufficiency. The area under the ROC curve (AUC) for baseline IL-6 AR to predict UF insufficiency was 0.663 (95% CI, 0.580–0.746; P < 0.001).ConclusionOur study suggested that the dialysate IL-6 AR could be a potential predictor of UF insufficiency in patients undergoing PD. |
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| spelling | doaj.art-a2429d463c58471c8fa9acd087e47bda2022-12-22T02:33:46ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-08-01910.3389/fmed.2022.836861836861High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort studyQianhui Song0Qianhui Song1Xiaoxiao Yang2Xiaoxiao Yang3Yuanyuan Shi4Yuanyuan Shi5Hao Yan6Hao Yan7Zanzhe Yu8Zanzhe Yu9Zhenyuan Li10Zhenyuan Li11Jiangzi Yuan12Jiangzi Yuan13Zhaohui Ni14Zhaohui Ni15Leyi Gu16Leyi Gu17Wei Fang18Wei Fang19Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Center for Peritoneal Dialysis Research, Shanghai, ChinaIntroductionUF insufficiency is a major limitation in PD efficiency and sustainability. Our study object to investigate the efficacy of intraperitoneal inflammation marker, IL-6 level as a predictor of UF insufficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsStable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6 AR). Patients were divided into two groups according to the median of IL-6 AR and prospectively followed up until death, transfer to permanent HD, recovery of renal function, kidney transplantation, transfer to other centers, lost to follow-up or to the end of study (January 31, 2021). Factors associated with UF capacity as well as dialysate IL-6 AR were assessed by multivariable linear regression. Cox proportional hazards model was used to examine the association between dialysate IL-6 AR and UF insufficiency.ResultsA total of 291 PD patients were enrolled, including 148 males (51%) with a mean age of 56.6 ± 14.1 years and a median PD duration of 33.4 (12.7–57.5) months. No correlation was found between dialysate IL-6 AR and UF capacity at baseline. PD duration was found positively correlated with baseline dialysate IL-6 AR, while 24h urine volume was negatively correlated with baseline dialysate IL-6 AR (P < 0.05). By the end of study, UF insufficiency was observed in 56 (19.2%) patients. Patients in the high IL-6 AR group showed a significantly inferior UF insufficiency-free survival when compared with their counterparts in the low IL-6 AR group (P = 0.001). In the multivariate Cox regression analysis, after adjusting for DM, previous peritonitis episode and 24h urine volume, higher baseline dialysate IL-6 AR (HR 3.639, 95% CI 1.776–7.456, P = 0.002) were associated with an increased risk of UF insufficiency. The area under the ROC curve (AUC) for baseline IL-6 AR to predict UF insufficiency was 0.663 (95% CI, 0.580–0.746; P < 0.001).ConclusionOur study suggested that the dialysate IL-6 AR could be a potential predictor of UF insufficiency in patients undergoing PD.https://www.frontiersin.org/articles/10.3389/fmed.2022.836861/fullinterleukin-6inflammationperitoneal dialysisultrafiltration capacityultrafiltration insufficiency |
| spellingShingle | Qianhui Song Qianhui Song Xiaoxiao Yang Xiaoxiao Yang Yuanyuan Shi Yuanyuan Shi Hao Yan Hao Yan Zanzhe Yu Zanzhe Yu Zhenyuan Li Zhenyuan Li Jiangzi Yuan Jiangzi Yuan Zhaohui Ni Zhaohui Ni Leyi Gu Leyi Gu Wei Fang Wei Fang High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study Frontiers in Medicine interleukin-6 inflammation peritoneal dialysis ultrafiltration capacity ultrafiltration insufficiency |
| title | High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study |
| title_full | High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study |
| title_fullStr | High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study |
| title_full_unstemmed | High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study |
| title_short | High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study |
| title_sort | high intraperitoneal interleukin 6 levels predict ultrafiltration uf insufficiency in peritoneal dialysis patients a prospective cohort study |
| topic | interleukin-6 inflammation peritoneal dialysis ultrafiltration capacity ultrafiltration insufficiency |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.836861/full |
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