Association of anemia and erythropoiesis stimulating agents with inflammatory biomarkers in chronic kidney disease

Kidney Int. 2008 Sep;74(6):782-90. doi: 10.1038/ki.2008.245. Epub 2008 Jun 11.

Abstract

Inflammatory cytokines are important predictors of cardiovascular mortality especially in patients with chronic kidney disease. Here we explored the relationship of anemia and epoetin treatment to inflammatory cytokine levels in patients with chronic kidney disease. One hundred non-dialysis patients with chronic kidney disease over 18 years of age were evenly split into anemic and non-anemic cohorts. Of the 50 anemic patients, 23 were receiving erythropoiesis stimulating agents treatments. Levels of tumor necrosis factor (TNF)-alpha were found to be significantly higher and serum albumin was significantly lower with trends towards higher interleukin (IL)-6 and IL-8 in anemic compared to non-anemic patients. Further analysis by multiple logistic regression found that anemic patients treated with erythropoiesis stimulating agents had significantly higher odds for the upper two quartiles for IL-6, IL-8 and TNF-alpha compared to non-anemic patients. Our study found that the anemia of chronic kidney disease was associated with up regulation of TNF-alpha, and possibly IL-6 and IL-8 along with increased levels of these proinflammatory cytokines in patients treated with epoetin.

Publication types

  • Controlled Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anemia / pathology*
  • Biomarkers / analysis
  • Case-Control Studies
  • Chronic Disease
  • Cytokines / analysis*
  • Epoetin Alfa
  • Erythropoietin / pharmacology*
  • Erythropoietin / therapeutic use
  • Female
  • Hematinics / pharmacology*
  • Hematinics / therapeutic use
  • Humans
  • Inflammation / diagnosis*
  • Interleukin-6 / analysis
  • Interleukin-8 / analysis
  • Kidney Diseases / complications
  • Kidney Diseases / pathology*
  • Male
  • Middle Aged*
  • Recombinant Proteins
  • Tumor Necrosis Factor-alpha / analysis
  • Up-Regulation

Substances

  • Biomarkers
  • Cytokines
  • Hematinics
  • Interleukin-6
  • Interleukin-8
  • Recombinant Proteins
  • Tumor Necrosis Factor-alpha
  • Erythropoietin
  • Epoetin Alfa