Elevated Serum Interleukin-18 Level is Correlated with Vascular Access Dysfunction in Patients on Maintenance Haemodialysis

Li Li You, Yuanhao Wu, Yin Zheng, Junfeng Liu, Jun Xue
2020 Annals of the Academy of Medicine, Singapore  
We evaluated the impact of serum interleukin-18 (IL-18) level on short-term vascular access (VA) function in chronic haemodialysis (HD) patients. Materials and Methods: Samples were collected from 80 clinically stable patients (58.8% were men) with a mean age of 60.9 years (standard deviation 11.7 years) who were undergoing maintenance HD and were followed up for 1 year. Multivariate logistic regression was used to analyse data on demographics, biochemical parameters and serum IL-18 level to
more » ... dict VA dysfunction events. The cut-off for IL-18 was derived from the highest score obtained on Youden index. Survival data was analysed using Cox proportional hazards regression analysis and Kaplan-Meier method. Results: Patients were classified as having either low IL-18 (<199.3 pg/mL) or high IL-18 (≥199.3 pg/mL). Multivariate logistic regression showed that serum IL-18 level was independently correlated with VA dysfunction events; patients with high IL-18 had a higher risk of VA dysfunction events than those with low IL-18 (odds ratio 9.47, 95% confidence interval 1.75–51.31, P = 0.009). In patients with high IL-18, Kaplan- Meier survival analysis found that incidence of VA dysfunction was significantly higher than patients with low IL-18 (P = 0.047). After adjustment for age, gender, inflammation (C-reactive protein) and calcium-phosphorus metabolism, decreased serum albumin and increased serum IL-18 levels were found to be independent prognostic predictors of VA dysfunction. Conclusion: HD patients with high IL-18 level tend to have worse rates of VA dysfunction. In HD outpatients, IL-18 is an independent risk factor for short-term VA dysfunction. Key words: Access survival, Cytokines, Short-term
doi:10.47102/annals-acadmedsg.2019239 fatcat:2x3m63onnvdnhb5x42syf57vxu