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J Am Soc Nephrol. 2015 Dec;26(12):3123-32. doi: 10.1681/ASN.2014080764. Epub 2015 Apr 8.

Plasma IL-6 and IL-10 Concentrations Predict AKI and Long-Term Mortality in Adults after Cardiac Surgery.

Author information

1
Program of Applied Translational Research, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut;
2
Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;
3
Program of Applied Translational Research, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Section of Nephrology, Veterans Affairs CT Healthcare System, West Haven, Connecticut;
4
Department of Clinical Epidemiology and Biostatistics.
5
Division of Cardiac Surgery, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada;
6
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada; and.
7
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;
8
Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada;
9
Division of General Internal Medicine, San Francisco Veterans Affairs Medical Center, University of California, San Francisco.
10
Program of Applied Translational Research, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Section of Nephrology, Veterans Affairs CT Healthcare System, West Haven, Connecticut; chirag.parikh@yale.edu.

Abstract

Inflammation has an integral role in the pathophysiology of AKI. We investigated the associations of two biomarkers of inflammation, plasma IL-6 and IL-10, with AKI and mortality in adults undergoing cardiac surgery. Patients were enrolled at six academic centers (n = 960). AKI was defined as a ≥ 50% or ≥ 0.3-mg/dl increase in serum creatinine from baseline. Pre- and postoperative IL-6 and IL-10 concentrations were categorized into tertiles and evaluated for associations with outcomes of in-hospital AKI or postdischarge all-cause mortality at a median of 3 years after surgery. Preoperative concentrations of IL-6 and IL-10 were not significantly associated with AKI or mortality. Elevated first postoperative IL-6 concentration was significantly associated with higher risk of AKI, and the risk increased in a dose-dependent manner (second tertile adjusted odds ratio [OR], 1.61 [95% confidence interval (95% CI), 1.10 to 2.36]; third tertile adjusted OR, 2.13 [95% CI, 1.45 to 3.13]). First postoperative IL-6 concentration was not associated with risk of mortality; however, the second tertile of peak IL-6 concentration was significantly associated with lower risk of mortality (adjusted hazard ratio, 0.75 [95% CI, 0.57 to 0.99]). Elevated first postoperative IL-10 concentration was significantly associated with higher risk of AKI (adjusted OR, 1.57 [95% CI, 1.04 to 2.38]) and lower risk of mortality (adjusted HR, 0.72 [95% CI, 0.56 to 0.93]). There was a significant interaction between the concentration of neutrophil gelatinase-associated lipocalin, an established AKI biomarker, and the association of IL-10 concentration with mortality (P = 0.01). These findings suggest plasma IL-6 and IL-10 may serve as biomarkers for perioperative outcomes.

KEYWORDS:

Epidemiology and outcomes; clinical epidemiology; cytokines; mortality

PMID:
25855775
PMCID:
PMC4657830
DOI:
10.1681/ASN.2014080764
[Indexed for MEDLINE]
Free PMC Article
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