Systemic and Intraperitoneal Interleukin-6 System during the First Year of Peritoneal Dialysis

Objective To investigate if intraperitoneal and systemic interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) are related to each other and to peritoneal solute transport rate (PSTR). Design Longitudinal study in retrospectively selected patients. Setting Peritoneal dialysis (PD) unit of a university-based hospital. Patients and Methods 31 PD patients on treatment with conventional glucose-based solutions participated in a longitudinal study. IL-6 and sIL-6R were measured in plasma and overnight effluent, both at baseline and after 12 ± 2 months on PD. C-reactive protein (CRP) and serum albumin were used as surrogate markers of inflammation. PSTR of small solutes was evaluated using the dialysate-to-plasma ratio (D/P) of creatinine after a 4-hour dwell; PSTR of large solutes was evaluated using the 24-hour D/P ratio of albumin. Results D/P creat increased over time (0.67 ± 0.15 vs 0.80 ± 0.11, p < 0.0001) and correlated to D/P albumin only at the baseline evaluation. Patients with plasma IL-6 ≥median had higher ( p < 0.005) D/P creat at baseline [0.74 (0.62 – 0.87)] compared to patients with IL-6 < median [0.57 (0.47 – 0.66)]. Dialysate IL-6 at baseline was also higher ( p < 0.05) in patients with plasma IL-6 ≥median [24.7 (16.5 – 38.5) pg/mL] compared to patients with IL-6 < median [14.1 (10 – 25.7) pg/mL]. Neither CRP nor albumin changed over time on PD, although they were closely linked to plasma IL-6 levels. A strong positive correlation was found between D/P creat and dialysate IL-6 (rho = 0.77, p < 0.0001) at baseline, but not at 1 year. In contrast, there was a significant correlation between D/P creat and dialysate sIL-6R (rho = 0.39, p < 0.05) at 1 year, but not at baseline. At 1 year, 17 patients with increasing PSTR had higher increases in dialysate IL-6 (28 ± 26 vs –21 ± 78 pg/mL, p < 0.05) and levels of dialysate sIL-6R (693 ± 392 vs 394 ± 274 pg/mL, p = 0.05) compared to patients with stable PSTR ( n = 11). Patients who had peritonitis presented higher baseline serum IL-6 concentration (6.8 ± 1.0 pg/mL) compared with patients without peritonitis (4.0 ± 0.6 pg/mL, p < 0.05). Finally, both at baseline and after 1 year, there were significant correlations between plasma and dialysate IL-6 (rho = 0.46, p < 0.05, and rho = 0.40, p < 0.05) respectively. Conclusions These findings indicate that, ( 1 ) intraperitoneal and systemic inflammation increase in PD patients during the first year of therapy; ( 2 ) intraperitoneal and systemic inflammation may be interrelated and the IL-6 system may be the link; ( 3 ) the IL-6 system (both intraperitoneal and systemic) is associated with PSTR, particularly in the early phase of PD treatment, in which small and large solute transport are linked. Signs of a transition between acute and chronic inflammation were observed in the follow-up evaluation. Inflammation may, at least in part, be responsible for the development of a high PSTR, and this could be one reason for the high mortality in patients with high PSTR.

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Effects of Interleukin-6 T15A Single Nucleotide Polymorphism on Baseline Peritoneal Solute Transport Rate in Incident Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080902900112 ◽

2009 ◽

Vol 29 (1) ◽

pp. 81-88 ◽

Cited By ~ 15

Author(s):

Young-Hwan Hwang ◽

Min-Jeong Son ◽

Jaeseok Yang ◽

Kiwon Kim ◽

Wookyung Chung ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Solute Transport ◽

Interleukin 6 ◽

Residual Renal Function ◽

Transport Rate ◽

Strong Positive Correlation ◽

Nucleotide Polymorphisms ◽

Necrosis Factor Alpha ◽

Single Nucleotide ◽

Peritoneal Solute Transport Rate

Objective To study the genetic effects of various inflammatory cytokines on peritoneal solute transport rate (PSTR) in incident Korean peritoneal dialysis (PD) patients. Design Case-control association study. Methods 132 patients with baseline peritoneal equilibration test within 1 – 3 months after starting PD were enrolled. We analyzed the influence of single nucleotide polymorphisms (SNPs) of interleukin-6 (IL-6; -572G/C, T15A), tumor necrosis factor-alpha (TNF-α; -1031C/T, -863C/A, -308G/A), and IL-10 (-1082A/G, -592A/C) on baseline PSTR. Clinical parameters such as age, gender, presence of diabetes mellitus, comorbidity, C-reactive protein, and residual renal function were also included as covariates. Results The T15A SNP of IL-6 (rs13306435) was associated with PSTR. Patients with TA genotype ( n = 18) had significantly lower D4/P creatinine (0.65 ± 0.087 vs 0.73 ± 0.110, p = 0.0046) and higher D4/D0 glucose (0.39 ± 0.174 vs 0.31 ± 0.119, p = 0.027) than patients with TT genotype ( n = 114). The log value of the dialysate appearance rate of IL-6 had a strong positive correlation with D4/P creatinine ( r2 = 0.1294, p < 0.0001) and was significantly lower in the TA genotype than the TT genotype (201.7 ± 14.42 vs 116.8 ± 88.91 pg/minute, p = 0.0358). By multiple logistic regression, TA genotype was negatively associated with a higher PSTR (high or high average; odds ratio 0.18; 95% confidence interval 0.048 – 0.666). Conclusions In incident Korean PD patients, T15A polymorphism of IL-6 is associated with dialysate IL-6 concentration and baseline PSTR.

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Investigating the Dimensionality and Stability of Union Commitment Profiles over a 10-Year Period: A Latent Transition Analysis

ILR Review ◽

10.1177/0019793919883815 ◽

2019 ◽

Vol 74 (1) ◽

pp. 224-254

Author(s):

Alexandre J. S. Morin ◽

Daniel G. Gallagher ◽

John P. Meyer ◽

David Litalien ◽

Paul F. Clark

Keyword(s):

Longitudinal Study ◽

Latent Transition Analysis ◽

First Year ◽

Multidimensional Approach ◽

Union Commitment ◽

Transition Analysis ◽

Positive Attitudes ◽

Commitment Level ◽

Person Centered Approach ◽

Over Time

The authors adopt a person-centered approach to the investigation of the dimensionality of the union commitment construct by capitalizing on a 10-year longitudinal study (from 1992 to 2002) of 637 union members in their first year of employment measured again 1 and 10 years later. Results reveal four distinct profiles of union commitment, presenting a stable structure over time. These profiles demonstrate consistency in commitment level across the three most common union commitment dimensions, thus questioning the necessity of adopting a multidimensional approach. Results show that union members became more similar to other members of their profiles over time, and that their union commitment became slightly less extreme as union tenure increased. Finally, results show that union commitment profiles predict union participation, in accordance with our expectations, and suggest that endorsing positive attitudes toward unions and their instrumentality was a stronger predictor of profile membership than was satisfaction with the actions of one’s own union.

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Dialysate interleukin-6 predicts increasing peritoneal solute transport rate in incident peritoneal dialysis patients

BMC Nephrology ◽

10.1186/1471-2369-15-8 ◽

2014 ◽

Vol 15 (1) ◽

Cited By ~ 22

Author(s):

Yeoungjee Cho ◽

David W Johnson ◽

David A Vesey ◽

Carmel M Hawley ◽

Elaine M Pascoe ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Solute Transport ◽

Interleukin 6 ◽

Transport Rate ◽

Dialysis Patients ◽

Peritoneal Solute Transport Rate

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Baseline Serum Interleukin-6 Predicts Cardiovascular Events in Incident Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00272 ◽

2015 ◽

Vol 35 (1) ◽

pp. 35-42 ◽

Cited By ~ 12

Author(s):

Yeoungjee Cho ◽

David W. Johnson ◽

David A. Vesey ◽

Carmel M. Hawley ◽

Elaine M. Pascoe ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Interleukin 6 ◽

Cardiovascular Events ◽

Regression Models ◽

Incidence Rate Ratio ◽

Degradation Products ◽

Significant Independent Predictor ◽

Baseline Serum ◽

Study Population ◽

Multilevel Linear Regression

BackgroundThe utility of local and systemic interleukin 6 (IL-6) as a prognostic marker in incident peritoneal dialysis (PD) patients remains to be fully defined. The present study aimed to explore the capacity of systemic IL-6 concentrations to predict cardiovascular events (CVEs) and mortality in PD patients, and to evaluate the influence of neutral-pH PD solutions low in glucose degradation products (GDPs) on systemic IL-6.MethodsThe study included 175 incident participants from the balANZ trial with at least one stored serum sample. A composite CVE score was used as the primary clinical outcome measure. Multilevel linear regression and Poisson regression models were fitted to describe, respectively, the trend of serum IL-6 over time and its ability to predict composite CVE.ResultsA significant increase in serum IL-6 from baseline to 24 months was observed in the study population (mean difference: 1.68 pg/mL; p = 0.006). The type of PD solution received by patients exerted no significant effect on serum IL-6 ( p = 0.12). Composite CVE was significantly and independently associated with baseline serum IL-6 (incidence rate ratio per picogram per milliliter: 1.06; 95% confidence interval: 1.02 to 1.10; p = 0.003).ConclusionsBaseline serum IL-6 was a significant independent predictor of composite CVE. Serum IL-6 concentrations increased with increasing PD duration and were not significantly modified with the use of biocompatible fluid over the study period. The present study is the first to link systemic IL-6 concentrations with CVE outcomes in incident PD patients.

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Systemic inflammatory response syndrome without systemic inflammation in acutely ill patients admitted to hospital in a medical emergency

Clinical Science ◽

10.1042/cs0960287 ◽

1999 ◽

Vol 96 (3) ◽

pp. 287-295 ◽

Cited By ~ 12

Author(s):

Annika TAKALA ◽

Irma JOUSELA ◽

Klaus T. OLKKOLA ◽

Sten-Erik JANSSON ◽

Marjatta LEIRISALO-REPO ◽

...

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Systemic Inflammation ◽

Interleukin 6 ◽

Systemic Inflammatory Response ◽

Composite Score ◽

C Reactive Protein ◽

Cd11b Expression ◽

Reactive Protein ◽

Markers Of Inflammation

Criteria of the systemic inflammatory response syndrome (SIRS) are known to include patients without systemic inflammation. Our aim was to explore additional markers of inflammation that would distinguish SIRS patients with systemic inflammation from patients without inflammation. The study included 100 acutely ill patients with SIRS. Peripheral blood neutrophil and monocyte CD11b expression, serum interleukin-6, interleukin-1β, tumour necrosis factor-α and C-reactive protein were determined, and severity of inflammation was evaluated by systemic inflammation composite score based on CD11b expression, C-reactive protein and cytokine levels. Levels of CD11b expression, C-reactive protein and interleukin-6 were higher in sepsis patients than in SIRS patients who met two criteria (SIRS2 group) or three criteria of SIRS (SIRS3 group). The systemic inflammation composite score of SIRS2 patients (median 1.5; range 0–8, n = 56) was lower than that of SIRS3 patients (3.5; range 0–9, n = 14, P = 0.013) and that of sepsis patients (5.0; range 3–10, n = 19, P< 0.001). The systemic inflammation composite score was 0 in 13/94 patients. In 81 patients in whom systemic inflammation composite scores exceeded 1, interleukin-6 was increased in 64 (79.0%), C-reactive protein in 59 (72.8%) and CD11b in 50 (61.7%). None of these markers, when used alone, identified all patients but at least one marker was positive in each patient. Quantifying phagocyte CD11b expression and serum interleukin-6 and C-reactive protein concurrently provides a means to discriminate SIRS patients with systemic inflammation from patients without systemic inflammation.

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Early Biochemical Markers of Inflammation in a Swine Model of Endotracheal Intubation

Anesthesiology ◽

10.1097/aln.0b013e3181788222 ◽

2008 ◽

Vol 109 (1) ◽

pp. 88-94 ◽

Cited By ~ 14

Author(s):

Carlos A. Puyo ◽

Sally M. Tricomi ◽

Thomas E. Dahms

Keyword(s):

Lactate Dehydrogenase ◽

Endotracheal Tube ◽

Interleukin 6 ◽

Ischemia Reperfusion Injury ◽

Ischemia Reperfusion ◽

Swine Model ◽

Polymorphonuclear Cells ◽

Lactate Dehydrogenase Activity ◽

Markers Of Inflammation ◽

Over Time

Background A common complaint after endotracheal tube use is sore throat, which may be due to abrasion, ischemia-reperfusion injury, or an inflammatory reaction. Few studies have evaluated localized tracheal inflammation as part of the response to intubation. Methods Inflammation of the trachea due to intubation was assessed in a swine model by following indicators of inflammation over time in the tracheal lumen. Repeated tracheal lavages proximal to the endotracheal tube cuff were performed, and recovered lavage was analyzed for cells, protein, lactate dehydrogenase, and cytokines. Results The baseline tracheal lavage samples contained 18% polymorphonuclear cells. These cells increased rapidly to 43% by 1 h. The polymorphonuclear cell increase from baseline was significant at 1, 2, and 4 h (P < 0.01) after intubation. Tumor necrosis factor alpha, interleukin 1beta, interleukin 6, and interleukin 8 increased over time, but only interleukin 6 increased significantly (P < 0.01). Interleukin 6 was not detected at baseline or 1 h, but was detected at 2 h and increased significantly by 4 h. Neither lavage protein concentration nor lactate dehydrogenase activity increased over time. Conclusions These results demonstrate that inflammation does occur during tracheal intubation, even when markers suggest minimal tracheal damage. The dramatic elevation in polymorphonuclear cells, along with the increase in interleukin 6, suggests an inflammatory response to the endotracheal tube itself or to some aspect of the intubation process. A more complete understanding of the response of the tracheal tissues is important in improving the treatment of intubated patients.

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Factors associated with different patterns of weight change after bariatric surgery: A longitudinal study

10.21203/rs.3.rs-960456/v1 ◽

2021 ◽

Author(s):

Diana Cristina Henao Carrillo ◽

Ana María Gómez ◽

Oscar Muñoz ◽

Claudia Rubio ◽

Natalia Rodríguez ◽

...

Keyword(s):

Physical Activity ◽

Bariatric Surgery ◽

Weight Loss ◽

Longitudinal Study ◽

Estimating Equation ◽

First Year ◽

Factors Associated ◽

Modifiable Factors ◽

Over Time

Abstract Background Bariatric surgery is the most effective treatment for obesity. During long-term follow-up, weight loss (WL) is variable between subjects. The aim of this study is to assess the change in percentage of total weight loss (%TWL) and excess weight loss (%EWL) and to describe the factors associated with greater or lesser WL over time. Methods Longitudinal study including patients treated with laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (LSG) and followed at Hospital Universitario San Ignacio, Bogotá (Colombia). Baseline data was recorded before surgery. Follow-up was performed at 3 (n=192), 6 (n=190), 9 (n=188), 12 (n=186), 24 (n=99) and 36 (n=30) months. Generalized Estimating Equation (GEE) analysis was used to assess the change in %TWL and %EWL over time. Results 196 patients were included (82.4% female, BMI 41.3±5.2 kg/m2). The tendency to increase on %TWL (31.6±6.6) and %EWL (80.2 RIQ 70.7-97.3) was evident in the first year, stabilizing after that. Nutritionist follow-up, baseline BMI>40 kg/m2 and WL≥10kg before surgery were associated with an average higher increase of %TWL (2.39% p=0.014, 0.41% p<0.001 and 0.37% p=0.003, respectively). Subjects who performed physical activity >30 minutes/day after surgery reduced %TWL in 0.74% (p=0.009). Similar findings were described on %EWL. Conclusion Follow-up during the first year after bariatric surgery is critical to achieving %TWL and %EWL goals. This study suggests that modifiable factors such as nutritional follow-up, WL before surgery and time of physical activity are associated with a significant change in %TWL and %EWL during follow-up by a multidisciplinary team.

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Acute Systemic Inflammation is Associated with an Increase in Peritoneal Solute Transport Rate in Chronic Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080402400621 ◽

2004 ◽

Vol 24 (6) ◽

pp. 597-600 ◽

Cited By ~ 9

Author(s):

Soon Bae Kim ◽

Jai Won Chang ◽

Sang Koo Lee ◽

Jung Sik Park

Keyword(s):

Peritoneal Dialysis ◽

Solute Transport ◽

Systemic Inflammation ◽

Acute Inflammation ◽

Transport Rate ◽

Temporary Increase ◽

Chronic Peritoneal Dialysis ◽

Hs Crp ◽

Inflammation Group ◽

Peritoneal Solute Transport Rate

Background This study was performed to evaluate the effects of acute systemic inflammation on peritoneal solute transport rate (PSTR) in chronic peritoneal dialysis (CPD) patients. Methods A baseline standard peritoneal equilibration test (PET) was performed on each patient every 6 months, and blood concentration of high-sensitivity C-reactive protein (hs-CRP) was assayed every 2 months in our peritoneal dialysis clinic. Acute systemic inflammation was defined as a greater than 10-fold increase in hs-CRP concentration compared with baseline value, in the absence of peritonitis, and returning to baseline level in 2 months. In patients with acute systemic inflammation, PET and hs-CRP concentration assays were performed during inflammation and after recovery. Ten patients with acute systemic inflammation were enrolled in the inflammation group and 42 other patients served as controls. Results There were no significant changes in hs-CRP and dialysate-to-plasma ratio of creatinine (D/Pcreat) in the control group during the study period. In the inflammation group, median hs-CRP levels at baseline, during acute inflammation, and at recovery were 2.3 mg/L (range 0.3 – 4.5 mg/L), 39.2 mg/L (range 15.1 – 117.4 mg/L), and 3.7 mg/L (range 0.9 – 8.9 mg/L), respectively. Median D/Pcreat increased significantly from baseline (0.64; range 0.55 – 0.98) to time of acute inflammation (0.72; range 0.60 – 0.96) ( p < 0.05). The D/Pcreat at recovery was 0.67 (range 0.52 – 0.94), which decreased significantly from time of acute inflammation ( p < 0.05). There was no correlation between changes in log (hs-CRP) and changes in D/Pcreat. Conclusion We have shown here that acute systemic inflammation is associated with a temporary increase in PSTR in CPD patients.

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