The relationship between IL-10 levels and cardiovascular events in patients with CKD

Yilmaz M. I., Solak Y., Saglam M., Cayci T., Acikel C., Unal H. U., ...Daha Fazla

Clinical Journal of the American Society of Nephrology, cilt.9, sa.7, ss.1207-1216, 2014 (SCI-Expanded, Scopus)

Özet

Background and objectives Cardiovascular disease is the leading cause of death in patients with CKD. IL-10 is considered an antiatherosclerotic cytokine. However, previous studies have failed to observe an association between IL-10 and cardiovascular disease in CKD. This study aimed to evaluate whether serumIL-10 levelswere associated with the risk of cardiovascular events in CKD patients. Design, setting, participants, & measurements Four hundred three patients with stages 1-5 CKD were followed for a mean of 38 (range=2-42)months for fatal and nonfatal cardiovascular events. IL-10 and IL-6weremeasured at baseline together with surrogates of endothelial function (flow-mediated dilatation) and proinflammatory markers (high-sensitivity C-reactive protein and pentraxin-3). The association between IL-10 and flow-mediated dilatation through linear regression analyses was evaluated. The association between IL-10 and the risk of cardiovascular events was assessed with Cox regression analysis. Results IL-10, IL-6, high-sensitivity C-reactive protein, and pentraxin-3 levels were higher among participants with lower eGFR. Both fatal (25 of 200 versus 6 of 203 patients) and combined fatal and nonfatal (106 of 200 versus 23 of 203 patients) cardiovascular events were more common in patients with IL-10 concentration above the median. Flow-mediated dilatation was significantly lower in patients with higher serum IL-10 levels, but IL-10 was not associated with flow-mediated dilatation in multivariate analysis. Kaplan-Meier survival curves showed that patients with IL-10 below the median value (,21.5 pg/ml) had higher cumulative survival compared with patients who had IL-10 levels above the median value (log-rank test, P,0.001). Conclusions IL-10 levels increase along with the reduction of kidney function. Higher serum IL-10 levels were associated with the risk of cardiovascular events during follow-up. We speculate that higher IL-10 levels in this context signify an overall proinflammatory milieu.