Interleukin-6 levels can be used to estimate cardiovascular and all-cause mortality risk in dialysis patients: A meta-analysis and a systematic review.
all-cause mortality
cardiovascular-related mortality
dialysis
interleukin-6
meta-analysis
Journal
Immunity, inflammation and disease
ISSN: 2050-4527
Titre abrégé: Immun Inflamm Dis
Pays: England
ID NLM: 101635460
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
revised:
03
03
2023
received:
19
10
2022
accepted:
07
03
2023
medline:
28
4
2023
pubmed:
27
4
2023
entrez:
27
4
2023
Statut:
ppublish
Résumé
Although previous studies have explored the correlation of interleukin (IL)-6 with mortality risk in dialysis patients, the findings have been conflicting. Hence, this meta-analysis aimed to comprehensively assess the use of IL-6 measurement for estimating cardiovascular mortality and all-cause mortality in dialysis patients. The Embase, PubMed, Web of Science, and MEDLINE databases were searched to identify relevant studies. After screening out the eligible studies, the data were extracted. Twenty-eight eligible studies with 8370 dialysis patients were included. Pooled analyses revealed that higher IL-6 levels were related to increased cardiovascular mortality risk (hazard ratio [HR] = 1.55, 95% confidence interval [CI]: 1.20-1.90) and all-cause mortality risk (HR = 1.11, 95% CI: 1.05-1.17) in dialysis patients. Further subgroup analyses suggested that higher IL-6 levels were associated with elevated cardiovascular mortality in hemodialysis patients (HR = 1.59, 95% CI: 1.36-1.81) but not in peritoneal dialysis patients (HR = 1.56, 95% CI: 0.46-2.67). Moreover, sensitivity analyses indicated that the results were robust. Egger's test revealed potential publication bias among studies exploring the correlation of IL-6 levels with cardiovascular mortality (p = .004) and all-cause mortality (p < .001); however, publication bias was not observed when using Begg's test (both p > .05). This meta-analysis reveals that higher IL-6 levels could indicate higher risks of cardiovascular mortality and all-cause mortality in dialysis patients. These findings suggest that monitoring IL-6 cytokine may help to enhance dialysis management and improve the general prognosis of patients.
Sections du résumé
BACKGROUND
Although previous studies have explored the correlation of interleukin (IL)-6 with mortality risk in dialysis patients, the findings have been conflicting. Hence, this meta-analysis aimed to comprehensively assess the use of IL-6 measurement for estimating cardiovascular mortality and all-cause mortality in dialysis patients.
METHODS
The Embase, PubMed, Web of Science, and MEDLINE databases were searched to identify relevant studies. After screening out the eligible studies, the data were extracted.
RESULTS
Twenty-eight eligible studies with 8370 dialysis patients were included. Pooled analyses revealed that higher IL-6 levels were related to increased cardiovascular mortality risk (hazard ratio [HR] = 1.55, 95% confidence interval [CI]: 1.20-1.90) and all-cause mortality risk (HR = 1.11, 95% CI: 1.05-1.17) in dialysis patients. Further subgroup analyses suggested that higher IL-6 levels were associated with elevated cardiovascular mortality in hemodialysis patients (HR = 1.59, 95% CI: 1.36-1.81) but not in peritoneal dialysis patients (HR = 1.56, 95% CI: 0.46-2.67). Moreover, sensitivity analyses indicated that the results were robust. Egger's test revealed potential publication bias among studies exploring the correlation of IL-6 levels with cardiovascular mortality (p = .004) and all-cause mortality (p < .001); however, publication bias was not observed when using Begg's test (both p > .05).
CONCLUSIONS
This meta-analysis reveals that higher IL-6 levels could indicate higher risks of cardiovascular mortality and all-cause mortality in dialysis patients. These findings suggest that monitoring IL-6 cytokine may help to enhance dialysis management and improve the general prognosis of patients.
Identifiants
pubmed: 37102647
doi: 10.1002/iid3.818
pmc: PMC10132186
doi:
Substances chimiques
Interleukin-6
0
Types de publication
Systematic Review
Meta-Analysis
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e818Informations de copyright
© 2023 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.
Références
Am J Kidney Dis. 2020 Jul;76(1):42-53
pubmed: 31932094
JAMA Netw Open. 2020 Sep 1;3(9):e2016197
pubmed: 32902652
J Exp Med. 2020 May 4;217(5):
pubmed: 32267936
ANZ J Surg. 2003 Sep;73(9):675-6
pubmed: 12956779
Cells. 2021 Apr 20;10(4):
pubmed: 33924019
Am J Nephrol. 2019;50(6):411-421
pubmed: 31630148
Medicina (Kaunas). 2019 Oct 16;55(10):
pubmed: 31623292
Nephrol Dial Transplant. 2011 Aug;26(8):2641-8
pubmed: 21325348
J Am Soc Nephrol. 2021 Aug;32(8):2020-2030
pubmed: 34244326
Nephrol Dial Transplant. 2004 Jun;19(6):1507-19
pubmed: 15069177
Clin J Am Soc Nephrol. 2016 Jul 7;11(7):1163-72
pubmed: 27281698
Nephrol Dial Transplant. 2008 Aug;23(8):2619-28
pubmed: 18334528
Front Pharmacol. 2021 Aug 24;12:745061
pubmed: 34504432
J Am Soc Nephrol. 2013 Dec;24(12):2071-80
pubmed: 24009237
Int J Mol Sci. 2019 Jun 01;20(11):
pubmed: 31159424
J Intern Med. 2003 Feb;253(2):153-60
pubmed: 12542555
Nephrol Dial Transplant. 2002 Sep;17(9):1684-8
pubmed: 12198224
Int J Artif Organs. 2015 May;38(5):237-43
pubmed: 26044660
Rev Bras Enferm. 2018 May;71(3):1115-1121
pubmed: 29924154
Am J Nephrol. 2021;52(9):745-752
pubmed: 34535589
Kidney Int. 2019 Jul;96(1):37-47
pubmed: 30987837
Cardiorenal Med. 2020;10(6):452-461
pubmed: 33238287
Hemodial Int. 2018 Oct;22(4):515-523
pubmed: 29775233
Clin J Am Soc Nephrol. 2011 Jul;6(7):1714-21
pubmed: 21642364
Am J Nephrol. 2009;29(2):129-35
pubmed: 18719346
Kidney Int. 2008 Nov;74(10):1335-42
pubmed: 18769368
Nephrol Dial Transplant. 2010 Aug;25(8):2662-71
pubmed: 20190238
Pol Arch Med Wewn. 2013;123(9):453-9
pubmed: 23978816
Front Physiol. 2019 Feb 18;10:105
pubmed: 30833904
Am J Kidney Dis. 2006 Jan;47(1):139-48
pubmed: 16377395
Biomark Med. 2020 Dec;14(17):1641-1649
pubmed: 33336590
Curr Opin Immunol. 2015 Jun;34:75-82
pubmed: 25749511
Ren Fail. 2020 Nov;42(1):282-288
pubmed: 32216514
Ann Noninvasive Electrocardiol. 2020 Nov;25(6):e12781
pubmed: 32638456
Am J Nephrol. 2009;30(4):389-98
pubmed: 19690405
Nephrol Dial Transplant. 2009 Dec;24(12):3826-33
pubmed: 19574337
Adv Clin Exp Med. 2019 Jan;28(1):133-135
pubmed: 30156388
F1000Res. 2020 Aug 20;9:
pubmed: 32864098
Circ Res. 2021 May 28;128(11):1728-1746
pubmed: 33998272
Clin J Am Soc Nephrol. 2020 Jan 7;15(1):132-151
pubmed: 31806658
Nephrology (Carlton). 2008 Oct;13(7):593-600
pubmed: 18826487
BMJ. 2021 Nov 29;375:e066306
pubmed: 34844936
Inflammopharmacology. 2018 Jun;26(3):685-698
pubmed: 29508109
Am J Transl Res. 2021 Sep 15;13(9):10485-10492
pubmed: 34650718
Blood Purif. 2017;43(1-3):210-217
pubmed: 28114138
J Am Soc Nephrol. 2020 Jul;31(7):1409-1415
pubmed: 32467113
Kidney Int Rep. 2018 May 03;3(5):1202-1213
pubmed: 30197987
Int Urol Nephrol. 2020 Jun;52(6):1135-1142
pubmed: 32306196
Am J Nephrol. 2011;33(2):157-67
pubmed: 21293117
Nat Rev Nephrol. 2020 Oct;16(10):573-585
pubmed: 32733095
Am J Kidney Dis. 2018 Mar;71(3):344-351
pubmed: 29174322
J Korean Med Sci. 2012 Apr;27(4):377-81
pubmed: 22468100
J Nephrol. 2019 Feb;32(1):111-119
pubmed: 30499038
Sci Rep. 2021 Jul 20;11(1):14768
pubmed: 34285273
Blood Purif. 2008;26(2):204-10
pubmed: 18285696
Ren Fail. 2013;35(5):680-5
pubmed: 23650973
Biomolecules. 2018 Aug 23;8(3):
pubmed: 30142970
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120