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Plasma inflammatory factors in older people predict acute kidney injury: a case–control study

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Key summary points

AbstractSection Aim

To investigate whether inflammatory factors are predictors of acute kidney injury (AKI) in older people in the intensive care unit (ICU).

AbstractSection Findings

Plasma inflammatory contents of IL-6 and IL-8 can predict AKI in older people. Management of inflammatory factors should take into consideration the age of AKI patients.

AbstractSection Message

Plasma inflammatory factors in older people predict acute kidney injury.

Abstract

Purpose

To investigate whether inflammatory factors are predictors of acute kidney injury (AKI) in older people in the intensive care unit (ICU).

Methods

We performed a case–control study that included 98 older people (≥ 65 years) who were admitted to ICU from 2013 to 2017. The contents of plasma pro-inflammatory factors [interleukin (IL)-1b, IL-6, IL-8, tumor necrosis factor-a (TNF-α)] and the anti-inflammatory factor IL-10 were determined at the first day of admission. Patients were assessed based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria and were divided into AKI and non-AKI (control) groups (n = 49 for each). T test was applied for differences comparisons in the levels of inflammatory factors between the two groups. Logistic regression was used to identify independent predictors of AKI.

Results

AKI patients had significantly elevated plasma contents of IL-6, IL-8 and IL-10, relative to the control group. A strong correlation was observed between IL-6 and IL-8 with AKI (OR 36.4 and 18.2, respectively). For each increase in the natural log unit in the levels of IL-6 and IL-8, the risk of developing AKI augmented by 36.4% and 18.2%, respectively. Moreover, the higher the tertile value of IL-6 and IL-8, the higher the risk of developing AKI. The area under the receiver operating characteristic curve for IL-6 and IL-8 was, respectively, 87% and 83% for predicting AKI.

Conclusion

Plasma inflammatory contents of IL-6 and IL-8 can predict AKI in older people. Management of inflammatory factors should take into consideration the age of AKI patients.

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Acknowledgements

The current study was funded by the National Natural Science Foundation of China (No. 81200017), the Foundation of Traditional Chinese and Western Medicine of General Hospitals in Shanghai (No. ZHYY-ZXYJHZX-2-201701) and the Foundation of Subject of Shanghai science and technology committee (18441905200).

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Author notes

  1. Li Han and Rong-rong Ren contributed equally to this work.

Authors and Affiliations

  1. Department of Gerontology, Xinhua Hospital, Shanghai Jiaotong University, Kongjiang Road 1665, Shanghai, 200092, China

    Li Han, Ling Yang & Jian-qiang Kang

  2. Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China

    Rong-rong Ren

  3. School of Data Science, Fudan University, Shanghai, China

    Kai-Lan Wan

Authors
  1. Li Han
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  2. Rong-rong Ren
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  3. Kai-Lan Wan
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  4. Ling Yang
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  5. Jian-qiang Kang
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Corresponding authors

Correspondence to Ling Yang or Jian-qiang Kang.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study was approved by Shanghai Jiaotong University Xinhua Hospital Ethics Committee (XHEC2011-002) and in accordance with the Declaration of Helsinki.

Informed consent

This was an observational study and all laboratory indices observed were commonly measured for all patients during the stay, the need for written informed consent was waived by the ethical review board.

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Han, L., Ren, Rr., Wan, KL. et al. Plasma inflammatory factors in older people predict acute kidney injury: a case–control study. Eur Geriatr Med 10, 905–911 (2019). https://doi.org/10.1007/s41999-019-00250-9

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  • DOI: https://doi.org/10.1007/s41999-019-00250-9

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