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Interferon-λ3 as a Predictor of Survival in Hemodialysis Patients.

[ Vol. 18 , Issue. 4 ]

Author(s):

A.E. Grzegorzewska*, M.K. Swiderska and W. Warchol   Pages 207 - 215 ( 9 )

Abstract:


Background: IFNL4 polymorphisms are associated with circulating IFN-λ3, and higher plasma IFN-λ3 are associated with higher production of antibodies to HBV surface antigen (anti-HBs). The IFNL4 rs8099917 T allele and anti-HBs development in response to HBV vaccine are associated with better survival in hemodialysis (HD) patients.

Objective: To show whether plasma IFN-λ3 is also a predictor of survival in HD patients.

Methods: Plasma IFN-λ3 was measured in 135 HD patients who were followed-up for 2.6 years. Survival probability was tested using the Kaplan-Meier method and the Cox proportional hazard model.

Results: Plasma IFN-λ3 (ng/L) was 116.8 (20.4–227.5) in survivors on HD (n=89, 65.9%), 75.1 (36.0-228.8) in deceased patients (n=37, 27.4%), and 109.0 (40.0–232.7) in subjects submitted to kidney transplantation (n=9, 6.7%). IFN-λ3 was lower in deceased patients than that in all remaining patients (P=0.039) and patients who continued HD without transplantation (P=0.028). IFN-λ3 and anti-HBs titers were correlated (r=0.587, P<0.000001). Patients showing IFN-λ3 >126.1 ng/L (3rd tertile) presented better survival compared with patients with IFN-λ3 in the 1st (<73.8 ng/L, P=0.005) and 2nd (≥73.8 - <126.1 ng/L, P=0.013) tertiles. Each decrease in IFN-λ3 per 10 ng/L was associated with a hazard ratio equal to 1.076 (95%CI 1.015–1.140, P=0.013). In multivariate analysis, the independent predictors of survival were age (P=0.008), dialysis modality (P=0.038), circulating IFN-λ3 (P=0.044), and diabetic nephropathy (P=0.047), but not gender, dialysis duration prior to the study, mean arterial pressure, BMI, CRP, albumin, 25(OH)D, or anti-HBs.

Conclusion: Circulating IFN-λ3 is a promising predictor of HD patient survival.

Keywords:

Anti-HBs, dialysis modality, end-stage renal disease, hemodialysis, interferon λ3, predictors of survival.

Affiliation:

Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences (PUMS), Poznan, Student Nephrology Research Group, Department of Nephrology, Transplantology and Internal Diseases, PUMS, Poznan, Department of Biophysics, PUMS, Poznan



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