Elevated serum soluble interleukin-2 receptor levels increase malignancy-related risk in patients on chronic hemodialysis
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Patients on chronic hemodialysis (HD) have an increased incidence of malignancy due to decreased immunity. Soluble interleukin-2 receptor (sIL-2R), as an immunomodulator, seemed to have an effect in the process of malignancy. In this study, we aimed to evaluate the clinical significance of increased sIL-2R in the course of malignancy among HD patients.
Patients who undergoing chronic hemodialysis were followed for 24 months. Risk factors for malignancy events and malignancy-related mortality during the 2-year follow-up period were investigated among various clinicopathological variables.
Of the 363 patients included in this research, 47 patients (12.95%) had a prior history of treated malignancy. During the 2-year follow-up period, malignancy events were detected in 15 (4.12%) patients. Sixty-seven patients died during the study period, of which nine patients (13.43%) were died of malignancy. Malignancy events reduced 2-year mortality significantly (log-rank = 23.02, P < 0.0001). Both high sIL-2R levels ( ≥ 2-fold upper limit of the normal value) (OR 6.6, P = 0.006) and a prior history of treated malignancy (OR 4.12, P = 0.018)were identified by multivariate logistic analysis as independent determinants for malignancy events. However, only the levels of sIL-2R (used as a continuous variable) had the significantly predictive effect on malignancy events and malignancy-related mortality in the following 2 years.
Elevated sIL-2R levels was commonly seen in serum of HD patients. And this elevated level increased the risk of malignancy. Aside from its role as a biomarker, sIL-2R may also exert biological effects in the course of malignancy.
KeywordsSoluble interleukin-2 receptor Hemodialysis Malignancy event Malignancy-related mortality
Soluble interleukin-2 receptor
End-stage renal disease
Tumor necrosis Factor α
Red blood cell distribution width
High-sensitivity C-reactive protein
Intact parathyroid hormone
Receiver operating characteristic
This study was founded by Shanghai Clinical Medical Center for Kidney Disease Project support by Shanghai Municipal Health Commission (no. 2017ZZ01015) and Shanghai Municipal Hospital Frontier Technology Project supported by Shanghai ShenKang Hospital Development Center (no. SHDC12018127).
Compliance with ethical standards
Conflict of interest
We declare no conflict of interest.
Informed consents were obtained from all individual participants included in the study.
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