Low serum free IL-18 is a novel potential marker for predicting infectious events in patients at dialysis initiation

• Published in: Clinical kidney journal Vol. 18; no. 5; p. sfaf094
• Main Authors: Tawara-Iida, Takashi, Usui, Joichi, Ebihara, Itaru, Ishizu, Takashi, Kobayashi, Masaki, Maeda, Yoshitaka, Kobayashi, Hiroaki, Yamagata, Kunihiro, Nakamura, Hideko, Takada, Kenji, Kozaki, Koichi, Iwabuchi, Satoshi, Iitsuka, Tadashi, Nishiki, Kenta, Takasaki, Hideaki, Takita, Takashi, Nakajima, Masami, Honma, Sumiko, Akai, Youichi, Ishizuka, Genzou, Issiki, Koichi, Saito, Takako, Iwamoto, Hitoshi, Ohishi, Akira, Ohtsuka, Masakazu, Ono, Atsushi, Kashiwabara, Hidehiko, Kanekawa, Takuro, Kanamori, Naoaki, Kaneda, Fumika, Kikuchi, Hiroshi, Kubo, Masashi, Kurosawa, Hiromi, Shiraishi, Takeshi, Shiigai, Tatsuo, Shima, Masayoshi, Takahashi, Tokuo, Matsukawa, Hideki, Tokoi, Minoru, Tsunematsu, Sadao, Tsuruta, Atsushi, Deguchi, Masao, Hayakawa, Masahiro, Hiroi, Makoto, Maeda, Nobuki, Hoshino, Takanobu, Yamaguchi, Tetsu, Yamada, Kota, Takeda, Atsushi, Takahashi, Ikuo, Yuhara, Takamichi, Kondo, Tadashi, Ooba, Syoji, Ogura, Yasunobu, Tachibana, Hisaya, Ookawa, Hiroshi, Fujii, Toshihiro
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2025
• Subjects: Analysis; Communicable diseases; Development and progression; Health aspects; Infection; Interleukins; Japan; Medical research; Medicine, Experimental; Mortality; Original; Prognosis; Protein binding; Rankings; Japan; infection; dialysis initiation; multicenter prospective cohort study; free IL-18
• ISSN: 2048-8505; 2048-8513
• DOI: 10.1093/ckj/sfaf094

Compared to the general population, individuals who are undergoing hemodialysis are at a higher risk of contracting severe infectious diseases, and their mortality rate from infectious diseases is also higher. We investigated the serum free interleukin-18 [free state of interleukin-18 (IL-18)] concentration as a prognostic factor for hemodialysis patients' infection risk. The Ibaraki Dialysis Initiation Cohort (iDIC) study is a multicenter prospective cohort investigation of patients undergoing a new initiation of dialysis in a local region of Japan. We performed a survival analysis of several events requiring hospitalization and compared the Kaplan-Meier curves of the "low" and "high" serum free IL-18 concentration groups. To adjust for confounding factors, we also performed a Cox proportional hazards analysis. We analyzed the serum free IL-18 concentration of samples from 295 patients randomly selected from the blood sample bank of the iDIC study. The mean free IL-18 concentration was 8.7 ± 5.3 pmol/l. The cumulative incidence of infectious events was significantly higher in the low free IL-18 group (<6.0 pmol/l, log-rank test < .01). The Cox proportional hazards analysis revealed that low serum free IL-18 (<6.0 pmol/l) was an independent factor associated with the development of infectious events. Total IL-18 and IL-18BP (binding protein) showed no association with infectious events. A low serum free IL-18 concentration in the dialysis initiation period is a potential marker for predicting the development of severe infection in these patients.