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NDT Advance Access published online on April 6, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp141
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Influence of interleukin-6 G-174C gene polymorphism on coronary artery disease, cardiovascular complications and mortality in dialysis patients

Sendogan Aker1, Christos Bantis1, Philip Reis1, Nicola Kuhr1, Christina Schwandt1, Bernd Grabensee1, Peter Heering2 and Katrin Ivens1

1 Department of Nephrology, Heinrich-Heine University 2 Staedtisches Klinikum Solingen, Germany

Correspondence and offprint requests to: Sendogan Aker; E-mail: basevision{at}yahoo.com



  Abstract

Background. Inflammation is a well recognized central component of atherosclerotic processes in chronic kidney disease. Interleukin-6 (IL-6) levels are a strong determinant of cardiovascular mortality in dialysis patients. We evaluated the impact of IL-6 gene G-174C polymorphism associated with modified IL-6 production on the development of coronary artery disease (CAD), cardiovascular events and mortality in chronic dialysis patients.

Methods. We studied n = 463 patients on chronic dialysis with angiographically confirmed (n = 218) or excluded (n = 245) CAD followed up for 65 months after initiation of dialysis. Monitored were arterial hypertension, diabetes mellitus, hyperlipidemia, smoking, CRP and fibrinogen. IL-6 gene G-174C polymorphism was determined by PCR amplification.

Results. The CC genotype was associated with an impaired patient survival (p < 0.05) remaining an independent risk factor for death in multivariate analysis (HR for CC genotype: 3.58, CI: 1.41-9.07, p < 0.01). CC genotype carrying CAD patients suffered significant frequently cardiovascular events (revascularization, myocardial infarction, death) compared to GG/GC genotype carriers (85.2% vs. 66.5, p < 0.05). However, the IL-6 gene G-174C polymorphism was not related to the onset and development of CAD itself (ns) and the inflammation parameters CRP and fibrinogen did not differ between the genotypes under investigation (ns).

Conclusions. Our results suggest that IL-6 gene G-174C polymorphism is associated with the incidence of cardiovascular events and mortality in chronic dialysis patients.

Keywords: cardiovascular; dialysis; gene polymorphism; interleukin-6; kidney

Received for publication: 1. 9.08
Accepted in revised form: 10. 3.09


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