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#6576 SERUM INTERLEUKIN-6 LEVELS AS A PREDICTOR OF ALL-CAUSE MORTALITY IN MAINTENANCE HEMODIALYSIS PATIENTS WITH COVID-19-OMICRON INFECTION: AN OBSERVATIONAL STUDY

Song, Qirong ; Luo, Yuxin ; Fu, Sha ; [weitere]

Oxford University Press (OUP) ; 2023

In: Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)

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In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)

Kurzfassung: Interleukin-6 (IL-6) is a key mediators of inflammation and has been linked to the severity and mortality of COVID-19-Omicron in the general population. With higher mortality rates observed in maintenance hemodialysis (MHD) patients infected with COVID-19-Omicron, the study aimed to examine the correlation between IL-6 levels and mortality in this patient population and to indentify the optimal IL-6 level for predicting the risk of death. Method The retrospective observational study was conducted in MHD patients diagnosed with COVID-19-Omicron infection between December 01, 2022 and January 31, 2023 at the Third Affiliated Hospital of Southern Medical University during the first wave of infection in COVID-19-Omicron outbreak in China. Clinical and biochemical data were collected during the infection, IL-6 levels of the patients were measured before consecutive dialysis sessions by a commercial kit. The Cox model was used to investigate the risk factors of mortality, meanwhile, ROC curve to determine the cut off value of IL-6 levels on mortality. Results A total of 162 MHD patients infected with COVID-19-Omicron were included in this study. During a median follow-up period of 40 days, 10 (6.2%) deaths occurred due to COVID-19 infection. IL-6 levels were significantly higher in patients who died. Univariate Cox regression analyses showed that the risk factors associated with death included IL-6 levels (HR: 1.009; p & lt;0.001), C-reactive protein (HR: 1.01; p = 0.016), serum potassium (HR: 2.258; p = 0.015, procalcitonin(PCT) (HR: 1.01; p = 0.048), and the Charlson comornidity index(CCI)(HR: 1.34; p = 0.002). However, in multivariate analysis, only IL-6 levels was independently associated with all-cause mortality(HR: 1.01; p = 0.001).The ROC curve and Kaplan-Meier survival analysis revealed a significantly worse survival risk among MHD patients with higher serum IL-6 levels (≥104.87 pg/mL) (sensitivity:100%; specificity:78.2%; AUC: 0.92; p = 0.001). Conclusion Serum IL-6 levels greater than 104.87 pg/mL were associated with an increased risk of all-cause mortality in MHD patients infected with COVID-19-Omicron. Hemoperfusion or hemofiltration to remove IL-6 may provide appropriate treatment options for hemodialysis patients with COVID-19-Omicron.

Materialart: Online-Ressource

ISSN: 0931-0509 , 1460-2385

URL: Article

DOI: 10.1093/ndt/gfad063c_6576

Sprache: Englisch

Verlag: Oxford University Press (OUP)

Publikationsdatum: 2023

ZDB Id: 1465709-0

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#5434 EFFICACY OF SACUBITRIL/VALSARTAN IN MAINTENANCE HEMODIALYSIS PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION

Fu, Sha ; Wang, Xiaohong ; Song, Qirong ; [weitere]

Oxford University Press (OUP) ; 2023

In: Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)

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In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)

Kurzfassung: Growing evidences have confirmed the effect of Sacubitril/Valsartan (SV) on hypertension and heart failure espacially EFrHF in general population. However, data on ARNI treatment in maintenance hemodialysis (MHD) patients with EfpHF are lacking. The present study was conducted to assess the efficacy and safety of sacubitril-valsartan in patients with HFpEF undergoing MHD. Method End-stage kidney disease (ESKD) patients undergoing MHD for more than 3 months with New York Heart Association (NYHA) class II–IV heart failure ejection fraction of 50% or higher, and elevated levels of N-terminal pro–B-type natriuretic peptide (NT-proBNP) were assigned to receive sacubitril-valsartan. Patients were followed up regularly after medication treatment. The alterations in clinical and biochemical parameters before and after taking sacubitril-valsartan (generally 50–200mg b.i.d) were investigated, and safety was also assessed. Results 120 patients were recruited in this study. Compared with baseline levels, NT-proBNP levels [7540.5 (3575.7–18373.0) vs. 4649.0 (2259.0–8187.0), P & lt;0.001], systolic blood pressure[(157.8 ± 20.5) vs.(141.5 ± 16.8), P & lt;0.001], diastolic blood pressure [(85.2 ± 14.9) vs.(78.5 ± 10.2), P & lt;0.001], heart rate[(78.1 ± 9.0) vs.(74.5 ± 6.9), P & lt;0.001], total cholesterol [4.7 ± 1.1 vs. 3.9 ± 1.3, P = 0.01] and Low Density Lipoprotein [2.4 ± 0.9 vs. 2.2 ± 1.1, P = 0.04] were markedly decreased after treatment with sacubitril-valsartan. The results of KCCQ scores[53.4 ± 16.1vs. 61.4 ± 15.7, P & lt;0.001] and NYHA classification [P = 0.01] showed obviously improvement after a median follow-up of 13 months. None of the patients showed adverse drug reactions. Conclusion Sacubitril/valsartan treatment improves significantly quality of life, symptoms of heart failure, NT-ProBNP and NYHA functional class in patients with HFpEF undergoing hemodialysis. Sacubitril/valsartan was safe and well tolerated.

Materialart: Online-Ressource

ISSN: 0931-0509 , 1460-2385

URL: Article

DOI: 10.1093/ndt/gfad063b_5434

Sprache: Englisch

Verlag: Oxford University Press (OUP)

Publikationsdatum: 2023

ZDB Id: 1465709-0

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