Tumor necrosis factor α is a risk factor for infection in peritoneal dialysis patients
The Korean Journal of Internal Medicine
;
: 722-729, 2016.
Article
in English
| WPRIM
| ID: wpr-67608
ABSTRACT
BACKGROUND/AIMS:
It has been shown that circulating tumor necrosis factor α (TNF-α) is elevated in end stage renal disease patients; however, the relationship between TNF-α and the development of infection in these patients is unknown. In this study, we investigated the association of plasma TNF-α and interleukin 6 (IL-6) with infection in peritoneal dialysis (PD) patients. We also evaluated the association of their plasma levels with the production by peripheral blood mononuclear cells (PBMC), and with various clinical parameters.METHODS:
We enrolled 32 patients on maintenance PD and 10 healthy controls. Plasma and PBMC were isolated from blood. PBMC were stimulated with lipopolysaccharide in vitro.RESULTS:
Mean follow-up duration was 775 days. Six patients developed organ infections (five pneumonia and one liver abscess), and six patients developed PD peritonitis and eight developed exit site infection. Plasma TNF-α and IL-6 levels were significantly elevated in organ infections but not in peritonitis or in exit site infection. Plasma TNF-α was the only significant risk factor for organ infections and pneumonia in multivariate regression analysis. Patients with high plasma TNF-α levels showed a significantly greater cumulative hazard rate for organ infections compared to those with low TNF-α levels. Plasma TNF-α levels correlated with TNF-α production by PBMC and showed an inverse association with Kt/V.CONCLUSIONS:
This is the first study showing that plasma TNF-α is a significant risk factor for infection in PD patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Peritonitis
/
Plasma
/
Pneumonia
/
In Vitro Techniques
/
Risk Factors
/
Follow-Up Studies
/
Interleukin-6
/
Peritoneal Dialysis
/
Tumor Necrosis Factor-alpha
/
Kidney Failure, Chronic
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2016
Type:
Article
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