Impact of chronic inflammation in patients with final stage chronic kidney disease on the risk of cardiovascular morbidity and mortality

Objective: To evaluate whether chronic inflammation objectified by increased levels of IL-6 in patients with end stage chronic kidney disease, increases the risk of cardiovascular morbidities (hypertension, cardiovas-cular disease, ejection fraction, myocardial ischemia, carotid calcifications etc.) with proven role in cardio-vascular mortality.

Methods: The study included 125 patients with CKD. They were divided into two groups according to whether or not they were undergoing dialysis: Dialysed and Non-Dialysed. CKD was defined as having a de-creased eGFR (<60mL/min/1.72m2) for more than 3 months and dialysis as undergoing renal substitutive therapy.

Results: Among the 125 patients under observation for chronic kidney disease, 63 (50.4%) were Dialysed (30% women and 70% men) and 62 (49.6%) were Non-Dialysed (52% women and 48% men). The mean age was 59.5 years. Our study showed that between the two groups, the non-dialysed patients were having in-creased levels of IL-6 compared to the non-dialysed (p<0.05). Regarding involvement of chronic inflamma-tion in cardiovascular morbidities, our study showed that there is a strong correlation between IL-6 and the decrease of ejection fraction objectified by a rou-tine echocardiography (p=0.0249); between IL-6 and myocardial ischemia objectified by EKG assessment (p=0.01), but there was not a strong correlation betwe-en IL-6 and carotid calcification objectified by vascular Doppler Echography (p=0.561); not a strong correlati-on between IL-6 and left ventricular hypertrophy ob-jectified by EKG and Echocardiography (p=0.94) and not a strong correlation between IL6 and cerebrovas-cular disease objectified by the history of the patient (p=0.06). Also chronic inflammation did not have a proven involvement in anaemia (common finding in patients with Heart Failure) objectified by low levels of Hb (p=0.6256) and Ferritin (p=0.3483), nor was is affected by the dialysis parameters: duration of dialysis (p=0.16), eKt/V (p=0.1424), vascular approach (p=0.771).

Conclusions: The study showed that both groups of pa-tients had chronic inflammation (more increased in the non-dialysed group) and that it is a strong correlation between IL-6 and the decreased ejection fraction and the presence of myocardial ischemia, but not a strong correlation between IL-6 and carotid calcification, left ventricular hypertrophy or cerebrovascular disease.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)