Status of interleukin-6 and hepcidin levels in first-time haemodialysis patients

Abstract

Background

The risk of chronic kidney disease stage 5 and its progression depend on the stage and the underlying diagnosis. Haemodialysis has become the long-term maintenance therapy for these patients. The interaction among interleukin-6 (IL-6), hepcidin and the iron exporter ferroportin is a major contributor to the iron-deficiency anaemia of chronic disease. The aim of the present study was to investigate the effects of polysulphone dialyzer membrane on serum IL-6 and hepcidin, including haemoglobin levels, in first-time patients undergoing five cycles of haemodialysis.

Patients and methods

Totally, 11 patients (male: five, female: six) were recruited for the present study after obtaining written informed consent. Their mean age was 57.4±13.4 years, and they were undergoing haemodialysis for the first time. Hepcidin, IL-6 and haemoglobin levels were determined before the first cycle and the fifth cycle and after the fifth cycle of haemodialysis. Pearson’s correlation coefficients were also determined.

Results and discussion

No statistically significant differences were observed before the first cycle and after the fifth cycle of haemodialysis in haemoglobin, IL-6 and hepcidin levels nor between pre-fifth and post-fifth cycle values, except for IL-6, which showed a significant mean reduction (P=0.04) from the pre-fifth cycle of 67.0 pg/ml to a mean value of 42.9 pg/ml (64.0% reduction). Analysis of variance showed no significant variation in the parameters studied, and no significant correlations between haemoglobin and IL-6, haemoglobin and hepcidin, and IL-6 and hepcidin were found.

Conclusion

In this short study of five-cycle haemodialysis, significant reduction in IL-6 with no significant change in hepcidin levels was found, even though severe anaemia was present. Kidney dysfunction probably results in decreased clearance of inflammatory markers and may not be improved by haemodialysis alone. Moreover, a different approach to reduce these markers is therefore warranted.