Inflammatory Markers and Outcomes in Kidney Transplant Recipients

BACKGROUNDIncreased levels of TNF-Alpha and IL6 are associated with inflammation and cardiovascular disease among patients with normal kidney function. However, little is known about their association with outcomes in kidney transplant recipients. METHODSWe collected socio-demographic, clinical and laboratory parameters, medical and transplant history from 977 prevalent kidney transplant recipients enrolled in the MINIT-HU study. Serum cytokine levels were measured at baseline. Associations between serum TNF-Alpha and IL6 values and death with a functioning graft over a 6-year follow-up period were examined in unadjusted and adjusted models. RESULTSThe mean±SD age of the study population was 51±13 years, 57% were men, 21% were diabetics. Median serum TNF-Alpha and IL6 concentrations were significantly higher in patients who died with a functioning graft as compared to those who did not die during the follow-up period (TNF-Alphamedian[IQR]1.92[1.43-2.67] vs. 2.25[1.63-3.08, p<0.001]pg/mL, and for IL6median[IQR]1.91[1.21-3.02] vs. 2.81[1.65-4.97]pg/mL, p<0.001). Higher serum TNF-Alpha and IL6 levels were associated with higher mortality risk in both unadjusted and fully adjusted modelsTNF-Alpha:HRs(1 pg/ml increments) (95%CI)1.24(1.13-1.36) and 1.19(1.08-1.32); IL6HRs(1 pg/ml increments)(95%CI)1.06(1.03-1.09) and 1.03(0.99-1.06), respectively. Compared to patients whose serum TNF-Alpha or IL6 levels were in the lowest tertile, those in the middle tertile had similar mortality risk (TNF-AlphaHR(95%CI)1.09(0.74-1.61); IL6HR(95%CI)1.05(0.68-1.62)), but patients in the highest tertile reported higher risk of mortalityTNF-AlphaHR(95%CI)1.45(1.01-2.09); IL6HR(95%CI)1.55(1.04-2.32) in multivariable adjusted models. CONCLUSIONSIn prevalent kidney transplant recipients, serum TNF-Alpha and IL6 were independently associated with death with a functioning graft..

Medienart:	Artikel

Erscheinungsjahr:	2016
Erschienen:	2016

Enthalten in:	Zur Gesamtaufnahme - year:2016
Enthalten in:	Transplantation - (2016), Seite 1

Sprache:	Englisch

Beteiligte Personen:	Molnar, Miklos Z [VerfasserIn] Nagy, Kristof [Sonstige Person] Remport, Adam [Sonstige Person] Tapolyai, Mihály B [Sonstige Person] Fülöp, Tibor [Sonstige Person] Kamal, Faisal [Sonstige Person] Kovesdy, Csaba P [Sonstige Person] Mucsi, Istvan [Sonstige Person] Mathe, Zoltan [Sonstige Person]

Links:	Volltext

BKL:	44.65

RVK:	RVK Klassifikation XA 10000

doi:	10.1097/TP.0000000000001548

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Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC1984347993