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Abstract: PO2286

Assessment of Circulating Inflammatory Cytokines Aids in the Prediction of Progression of CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Doyle, Ross, University College Dublin, Dublin, Ireland
  • Murray, Susan Louise, Royal College of Surgeons in Ireland, Dublin, Ireland
  • Brennan, Eoin, University College Dublin, Dublin, Ireland
  • Conlon, Peter J., Royal College of Surgeons in Ireland, Dublin, Ireland
  • Sadlier, Denise M., Mater Misericordiae University Hospital, Dublin, Ireland
  • Godson, Catherine, University College Dublin, Dublin, Ireland
Background

Though Chronic Kidney Disease (CKD) is common, only a small proportion of patients progress towards the need for dialysis or transplantation. Understanding the factors which drive progression of CKD may facilitate better prediction of outcomes for patients and streamline patient care.

Methods

Inflammatory cytokines, IL-6, IL-10 and TNF-α were measured in patients with CKD. Clinical data, including demographic, biochemical, histological, and longitudinal assessments of renal function were collected for these patients. Differences in levels of circulating inflammatory cytokines were examined using independent samples, two-sided T tests, with α < 0.05. Linear regression models, using bootstrap resampling were explored to identify the ability of these cytokines to explain future eGFR. Cox proportional hazards models were explored to examine predictors of progression of CKD, defined as the need to commence dialysis or undergo transplantation.

Results

Levels of inflammatory cytokines were assessed in 226 patients with kidney disease. Higher levels were seen in those patients who experienced progression of CKD. 14% of the variance in eGFR at 12 month follow-up was explained by IL-6 levels at baseline (bias -0.0039, SE 0.036). TNF-α levels were predicted to explain 21% of 12 month eGFR (bias -0.005, SE 0.07). In a Cox proportional hazards model, patients with the highest quartile of IL-10 measurements were more likely to experience CKD progression towards the need for dialysis or transplantation (HR 4.99, 95% CI 1.62-15.32) (Likelihood ratio test = 45, on 13 df, p = 2x10-5). Patients with lower levels of tubulointerstitial fibrosis (<50% on kidney biopsy) were less likely to experience progression of CKD (HR 0.38, 95% CI 0.19-0.73).

Conclusion

Higher levels of inflammatory cytokines in patients with CKD are predictive of eGFR decline and may be incorporated in models to help predict outcomes for CKD patients.

Funding

  • Private Foundation Support