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

Cho, Yeoungjee, Johnson, David W., Vesey, David A., Hawley, Carmel M., Pascoe, Elaine M., Clarke, Margaret, Topley, Nicholas and on behalf of the balANZ Trial Investigators (2014) Dialysate interleukin-6 predicts increasing peritoneal solute transport rate in incident peritoneal dialysis patients. BMC Nephrology, 15 1: . doi:10.1186/1471-2369-15-8


Author Cho, Yeoungjee
Johnson, David W.
Vesey, David A.
Hawley, Carmel M.
Pascoe, Elaine M.
Clarke, Margaret
Topley, Nicholas
on behalf of the balANZ Trial Investigators
Total Author Count Override 7
Title Dialysate interleukin-6 predicts increasing peritoneal solute transport rate in incident peritoneal dialysis patients
Journal name BMC Nephrology   Check publisher's open access policy
ISSN 1471-2369
Publication date 2014-01-10
Year available 2014
Sub-type Article (original research)
DOI 10.1186/1471-2369-15-8
Open Access Status DOI
Volume 15
Issue 1
Total pages 9
Place of publication London, United Kingdom
Publisher BioMed
Collection year 2015
Language eng
Formatted abstract
Background
Repeated exposure to peritoneal dialysis (PD) solutions contributes to cumulative intraperitoneal inflammation and peritoneal injury. The present study aimed to explore the capacity of dialysate interleukin-6(IL-6) to a) predict peritoneal membrane function and peritonitis in incident PD patients, and b) to evaluate the influence of neutral pH, low glucose degradation product (GDP) PD solution on dialysate IL-6 levels.

Methods
The study included 88 incident participants from the balANZ trial who had completed 24-months of follow-up. Change in peritoneal solute transport rate (PSTR) and peritonitis were primary outcome measures, and the utility of IL-6 and IL-6 appearance rate (IL-6 AR) in predicting these outcomes was analyzed using multilevel linear regression and Cox proportional hazards models, respectively. Sensitivity analyses were performed by analyzing outcomes in a peritonitis-free cohort (n = 56).

Results

Dialysate IL-6 concentration significantly increased from baseline to 24 months (mean difference 19.07 pg/mL; P < 0.001) but was not affected by the type of PD solution received (P = 0.68). An increase in PSTR from baseline was associated with higher levels of IL-6 (P = 0.004), the use of standard solutions (P = 0.005) and longer PD duration (P < 0.001). Baseline IL-6 level was not associated with a shorter time to first peritonitis (adjusted hazard ratio 1.00, 95% CI 0.99-1.00, P = 0.74). Analysis of IL-6 AR as well as sensitivity analyses in a peritonitis-free cohort yielded comparable results.

Conclusion

Dialysate IL-6 concentration increased with longer PD duration and was a significant, independent predictor of PSTR. The use of biocompatible PD solutions exerted no significant effect on dialysate IL-6 levels but did abrogate the increase in PSTR associated with standard PD solutions. This is the first study to examine the impact of biocompatible solutions on the utility of IL-6 in predicting PSTR and peritonitis.
Keyword Biocompatible
Glucose degradation products
Interleukin-6
Peritoneal dialysis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article number 8.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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