Dialysis patients with high levels of the
cytokine interleukin 6 (IL-6) may have greater risks for progression of coronary
artery calcification (CAC) and death, according to new research presented
during the live virtual National Kidney Foundation 2020
Spring Clinical Meetings.
Neil Roy, MBBS, and Sylvia E. Rosas, MD,
MSCE, of Joslin Diabetes Center, Harvard Medical School, Boston, studied CAC
progression in 101 incident dialysis patients (mean age 50.6 years; 33% women;
and 64.7% black) using electrocardiogram-triggered multi-slice computed
tomography scans. At baseline, Agatston calcium scores for individuals with
high vs low IL-6 (using a median 3.1 pg/mL as a cutoff) were 55.2 vs 4.75. Over
12 months, patients’ calcium scores increased to 120.9 and 22.1, respectively.
Although a quarter of all patients
died over 5 years, the investigators found that a significantly greater
proportion of patients with high compared with low IL-6 (28% vs 18%). On
multivariable linear regression, IL-6 emerged as an independent risk factor for
CAC progression. Each log increase in IL-6 was associated with a 2.4-fold increase
in death risk. Fibroblast growth factor 23, smoking, and diabetes were not found
to be major contributors.
“This study demonstrates
that inflammation is an important pathway for cardiovascular disease progression
even in patients on dialysis,” Drs Roy and Rosas told Renal & Urology News. “We should find ways to decrease
inflammation in our patients that include diet, glucose control, and increased
physical activity among other efforts. In addition, future studies should
assess whether curbing inflammation actually reduces cardiovascular events and
improves survival in these high-risk patients.”
Read more of our coverage of the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings by visiting the conference page.
Reference
Roy N, Rosas S. IL-6 is associated with progression of coronary arterial calcification (CAC) and mortality in patients new to dialysis. Data presented at the live virtual National Kidney Foundation 2020 Spring Clinical Meetings held March 25 to 29. ePoster 294.
