Low serum free IL-18 is a novel potential marker for predicting infectious events in patients at dialysis initiation.

IF 3.9 2区医学 Q1 UROLOGY & NEPHROLOGY

Clinical Kidney Journal Pub Date : 2025-04-09 eCollection Date: 2025-05-01 DOI:10.1093/ckj/sfaf094

Takashi Tawara-Iida, Joichi Usui, Itaru Ebihara, Takashi Ishizu, Masaki Kobayashi, Yoshitaka Maeda, Hiroaki Kobayashi, Kunihiro Yamagata

{"title":"Low serum free IL-18 is a novel potential marker for predicting infectious events in patients at dialysis initiation.","authors":"Takashi Tawara-Iida, Joichi Usui, Itaru Ebihara, Takashi Ishizu, Masaki Kobayashi, Yoshitaka Maeda, Hiroaki Kobayashi, Kunihiro Yamagata","doi":"10.1093/ckj/sfaf094","DOIUrl":null,"url":null,"abstract":"Background: Compared to the general population, individuals who are undergoing hemodialysis are at a higher risk of contracting severe infectious diseases, and their mortality rate from infectious diseases is also higher. We investigated the serum free interleukin-18 [free state of interleukin-18 (IL-18)] concentration as a prognostic factor for hemodialysis patients' infection risk.Methods: The Ibaraki Dialysis Initiation Cohort (iDIC) study is a multicenter prospective cohort investigation of patients undergoing a new initiation of dialysis in a local region of Japan. We performed a survival analysis of several events requiring hospitalization and compared the Kaplan-Meier curves of the \"low\" and \"high\" serum free IL-18 concentration groups. To adjust for confounding factors, we also performed a Cox proportional hazards analysis.Results: We analyzed the serum free IL-18 concentration of samples from 295 patients randomly selected from the blood sample bank of the iDIC study. The mean free IL-18 concentration was 8.7 ± 5.3 pmol/l. The cumulative incidence of infectious events was significantly higher in the low free IL-18 group (<6.0 pmol/l, log-rank test P < .01). The Cox proportional hazards analysis revealed that low serum free IL-18 (<6.0 pmol/l) was an independent factor associated with the development of infectious events. Total IL-18 and IL-18BP (binding protein) showed no association with infectious events.Conclusion: A low serum free IL-18 concentration in the dialysis initiation period is a potential marker for predicting the development of severe infection in these patients.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf094"},"PeriodicalIF":3.9000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044333/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Kidney Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ckj/sfaf094","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Compared to the general population, individuals who are undergoing hemodialysis are at a higher risk of contracting severe infectious diseases, and their mortality rate from infectious diseases is also higher. We investigated the serum free interleukin-18 [free state of interleukin-18 (IL-18)] concentration as a prognostic factor for hemodialysis patients' infection risk.

Methods: The Ibaraki Dialysis Initiation Cohort (iDIC) study is a multicenter prospective cohort investigation of patients undergoing a new initiation of dialysis in a local region of Japan. We performed a survival analysis of several events requiring hospitalization and compared the Kaplan-Meier curves of the "low" and "high" serum free IL-18 concentration groups. To adjust for confounding factors, we also performed a Cox proportional hazards analysis.

Results: We analyzed the serum free IL-18 concentration of samples from 295 patients randomly selected from the blood sample bank of the iDIC study. The mean free IL-18 concentration was 8.7 ± 5.3 pmol/l. The cumulative incidence of infectious events was significantly higher in the low free IL-18 group (<6.0 pmol/l, log-rank test P < .01). The Cox proportional hazards analysis revealed that low serum free IL-18 (<6.0 pmol/l) was an independent factor associated with the development of infectious events. Total IL-18 and IL-18BP (binding protein) showed no association with infectious events.

Conclusion: A low serum free IL-18 concentration in the dialysis initiation period is a potential marker for predicting the development of severe infection in these patients.

查看原文本刊更多论文

低血清游离IL-18是预测透析开始时患者感染事件的一种新的潜在标志物。

背景：与一般人群相比，接受血液透析的个体感染严重传染病的风险更高，其传染病死亡率也更高。我们研究了血清游离白介素-18 （IL-18）浓度作为血液透析患者感染风险的预后因素。方法：茨城县透析起始队列（iDIC）研究是一项多中心前瞻性队列研究，研究对象是日本一个地区新开始透析的患者。我们对几个需要住院治疗的事件进行了生存分析，并比较了“低”和“高”血清游离IL-18浓度组的Kaplan-Meier曲线。为了校正混杂因素，我们还进行了Cox比例风险分析。结果：我们分析了从iDIC研究的血液样本库中随机抽取的295例患者的血清游离IL-18浓度。平均游离IL-18浓度为8.7±5.3 pmol/l。结论：透析起始期血清游离IL-18浓度低是预测患者发生严重感染的潜在指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Kidney Journal Medicine-Transplantation

CiteScore

6.70

自引率

10.90%

发文量

242

审稿时长

8 weeks

期刊介绍： About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.