Intra-peritoneal interleukin-6 system is a potent determinant of the baseline peritoneal solute transport in incident peritoneal dialysis patients

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2010-05, Vol.25 (5), p.1639-1646
• Main Authors: Oh, Kook-Hwan, Jung, Ji Yong, Yoon, Myeong Ok, Song, Aeran, Lee, Hajeong, Ro, Han, Hwang, Young-Hwan, Kim, Dong Ki, Margetts, Peter, Ahn, Curie
• Format: Article
• Language: English
• Subjects: Adult; Aged; albumin appearance rate; Albumins - metabolism; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Angiopoietin-2 - blood; Biological and medical sciences; Biological Transport; CA-125 Antigen - blood; Chemokine CCL2 - blood; Creatinine - metabolism; Emergency and intensive care: renal failure. Dialysis management; Female; Glomerulonephritis; Humans; Intensive care medicine; interleukin-6; Interleukin-6 - blood; Male; MCP-1; Medical sciences; Middle Aged; Multivariate Analysis; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Peritoneal Dialysis; Peritoneum - metabolism; PSTR; Vascular Endothelial Growth Factor A - blood
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfp670

Background. Interleukin-6 (IL-6) is a key player in modulating inflammation. IL-6 and soluble IL-6 receptor (sIL-6R) complex induces the synthesis and secretion of various chemokines, adhesion molecules and angiogenic molecules. We hypothesized that the baseline peritoneal solute transport rate (PSTR) early after commencing peritoneal dialysis (PD) may depend largely on the IL-6/sIL-6R system. We also hypothesized that the dialysate concentrations of IL-6/sIL-6R could be closely related to local inflammation or angiogenesis in the peritoneal cavity. Methods. Fifty incident patients with a modified peritoneal equilibration test result within 3 months after commencing PD and without a previous history of peritonitis were enrolled. Clinical parameters such as age, sex, comorbid disease, body mass index, residual renal function and C-reactive protein were assessed. Serum and dialysate markers including CA125, IL-6, sIL-6R, monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) were measured and correlated with PSTR. Results. Dialysate concentrations of IL-6 (r = 0.576, P < 0.001), MCP-1 (r = 0.408, P = 0.003) and Ang-2 (r = 0.408, P = 0.003) correlated with mass transfer area coefficient for creatinine (MTACcr), respectively. Dialysate appearance rate (AR) of albumin correlated with dialysate concentrations of CA125 (r = 0.751, P < 0.001), IL-6 (r = 0.303, P = 0.039), sIL-6R (r = 0.497, P < 0.001), MCP-1 (r = 0.488, P < 0.001), VEGF (r = 0.443, P = 0.004) and Ang-2 (r = 0.488, P < 0.001). Neither MTACcr nor AR of albumin was associated with systemic markers. Multivariate analysis showed that MTACcr is independently associated with dialysate IL-6 and serum albumin. It also showed that AR of albumin is independently predicted by dialysate sIL-6R. Dialysate IL-6 correlated with dialysate concentrations of CA125 MCP-1, VEGF and Ang-2. Conclusion. Our study from incident PD patients suggested that (i) dialysate the IL-6 system is a potent determinant of baseline PSTR and (ii) elevation of IL-6 in the dialysate is associated with up-regulation of intra-peritoneal inflammatory and angiogenic molecules.