Prognostic role of C-reactive protein and Interleukin-6 in dialysis patients: A systematic review and meta-analysis

Inflammation may be associated with mortality in dialysis patients. This study aims to summarize the prognostic value of two common inflammatory markers, C-reactive protein (CRP) and Interleukin-6 (IL-6) for dialysis outcome. A total of 109 CRP studies and 22 IL-6 studies were identified from PubMed and EMBASE after systematic searching and assessment. The combined hazard ratios (HRs) of CRP and IL-6 for mortality were analyzed. For all-cause mortality (ACM), both CRP and IL-6 could significantly predict the outcome, with the pooled HRs of 1.142 (95%CI: 1.118-1.166) and 1.152 (95%CI: 1.094-1.214) for CRP and IL-6, respectively. For cardiovascular disease mortality (CVDM), the pooled HR of CRP (1.182, 95%CI: 1.134-1.232) was close to that of IL-6 (1.181, 95%CI: 1.068-1.307). Therefore, elevated levels of CRP or IL-6 were significantly associated with higher ACM and higher CVDM in dialysis patients. The predictive value of the inflammatory biomarkers may be useful in clinical practice.