Interleukin 6 is a better predictor of 5-year cardiovascular mortality than high-sensitivity C-reactive protein in hemodialysis patients using reused low-flux dialyzers

Background. Renal anemia is a common complication of hemodialysis patients. Erythropoietin (EPO) hyporesponsiveness has been recognized as an important factor to poor efficacy of recombinant human erythropoietin in the treatment of renal anemia. More importantly, increased erythropoiesis resistance index (ERI) may be associated with inflammation and increased mortality. Objective. The objective of this research was to investigate correlated factors of EPO responsiveness and to clarify the relationships between EPO hyporesponsiveness and cardiovascular mortality and all-cause mortality among maintenance hemodialysis patients. Methods. This prospective cohort study enrolled 276 maintenance hemodialysis patients for a 55-month follow-up to investigate the factors related to ERI and its relationship to all-cause mortality and cardiovascular mortality. Results. ERI was positively correlated with predialysis serum high-sensitivity C-reactive protein ( r = 0.234 , p < 0.001 ), alkaline phosphatase ( r = 0.134 , p = 0.028 ), and ferritin ( r = 0.155 , p = 0.010 ) and negatively correlated with albumin ( r = − 0.206 , p < 0.001 ) and creatinine ( r = − 0.232 , p < 0.001 ). As multiple linear regression showed, predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of ERI ( p < 0.05 ). Kaplan–Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with ERI > 11.04 IU / kg / w / g / dL (both p < 0.01 ). The high ERI group was significantly associated with higher risk for all-cause mortality (OR 1.781, 95% CI 1.091 to 2.910, p = 0.021 ) and cardiovascular mortality (OR 1.972, 95% CI 1.139 to 3.417, p = 0.015 ) after adjusting for confounders. Conclusions. Predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of EPO responsiveness among maintenance hemodialysis patients. Patients with higher ERI values had a higher all-cause mortality rate and cardiovascular mortality rate.

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Effects of simvastatin on high-sensitivity C-reactive protein and serum albumin in hemodialysis patients

American Journal of Kidney Diseases ◽

10.1053/ajkd.2002.33393 ◽

2002 ◽

Vol 39 (6) ◽

pp. 1213-1217 ◽

Cited By ~ 105

Author(s):

Jai Won Chang ◽

Won Seok Yang ◽

Won Ki Min ◽

Sang Koo Lee ◽

Jung Sik Park ◽

...

Keyword(s):

Serum Albumin ◽

High Sensitivity ◽

Hemodialysis Patients ◽

C Reactive Protein ◽

Reactive Protein

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Baseline high-sensitivity C-reactive protein to predict progression-free survival in metastatic renal cell carcinoma patients treated with first-line sunitinib.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15527 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15527-e15527

Author(s):

Ryuichi Mizuno ◽

Go Kimura ◽

Tsunenori Kondo ◽

Takeshi Ueda ◽

Hidehiko Hara ◽

...

Keyword(s):

Interleukin 6 ◽

Inflammatory Markers ◽

Progression Free Survival ◽

High Sensitivity ◽

C Reactive Protein ◽

First Line ◽

Free Survival ◽

Reactive Protein ◽

Hs Crp ◽

Serum Inflammatory Markers

e15527 Background: Predicting the efficacy of tyrosine kinase inhibitors (TKI) would be of clinical value in patients with metastatic renal cell carcinoma (mRCC). We tested the hypothesis that serum inflammatory markers are associated with clinical outcome in mRCC patients at favorable or intermediate prognostic risk treated with first-line sunitinib. Methods: Eighty-nine mRCC patients were prospectively monitored at baseline (day 0) during sunitinib treatment. Serum interleukin-6 and 8 levels were determined by CLEIA and ELISA, respectively. A high-sensitivity C-reactive protein (hs-CRP) levels were measured using laser nephelometry. Correlations between baseline interleukin-6, 8, hs-CRP levels and response to sunitinib, and progression-free survival (PFS) were examined. Results: Median PFS was 9.2 months. Clinical benefit rate (CBR; percent complete responses+partial responses +stable disease 24 weeks) was 57.3%. Baseline interleukin-8 (P=0.0240) and hs-CRP (P=0.0060) was associated with CBR. No association between baseline interleukin-6 and 8 with PFS was observed. However, baseline hs-CRP were associated with PFS (P=0.0016; unit risk 1.010; 95% CI 1.004 to 1.017). Conclusions: Baseline serum inflammatory markers could be of clinical interest in sunitinib-treated mRCC patiens to predict outcome. Baseline hs-CRP serum levels warrant further study. Clinical trial information: UMIN000009622.

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