IL-6 Versus TNF-α as Predictors of Echocardiographic Cardiac Remodeling in Maintenance Hemodialysis Patients.

Background and

Objectives

Cardiovascular disease remains the leading cause of mortality in end-stage renal disease, with systemic inflammation implicated in myocardial remodeling. We aimed to assess the associations between IL-6, TNF-α, and IL-1β and echocardiographic parameters of cardiac remodeling, including left ventricular mass (LVM), global longitudinal strain (GLS), interventricular septum (IVS), left ventricular end-diastolic diameter (LVEDD), and right ventricular diameter (RVD), in patients undergoing maintenance hemodialysis. This was a single-center retrospective observational study. Materials and

Methods

In 58 maintenance hemodialysis patients (mean age 60.4 ± 11.7 years; 55% male), pre-dialysis serum cytokines (IL-6, TNF-α, IL-1β) and standard laboratory markers (C-reactive protein [CRP], albumin, hemoglobin) were measured. Echocardiography was performed under clinically stable conditions. Spearman correlations assessed relationships between cytokines and imaging parameters; multivariate linear regression identified independent predictors.

Results

Median IL-6 was 7.36 pg/mL (interquartile range [IQR] 4.52-11.03), and median TNF-α was 9.35 pg/mL (IQR 7.9-12.57). IL-6 correlated positively with LVM (ρ = 0.63, p < 0.001), RVD (ρ = 0.53, p < 0.001), and CRP (ρ = 0.52, p < 0.001). In contrast, TNF-α inversely correlated with LVM (ρ = -0.36, p = 0.006). Multivariate regression showed IL-6 was independently predicted by LVM (p = 0.019) and RVD (p = 0.042), while TNF-α was predicted by age (p < 0.001), CRP (p = 0.038), and albumin (p = 0.012).

Conclusions

In hemodialysis patients, IL-6 showed stronger associations with echocardiographic hypertrophy and dilation than TNF-α, supporting its role as a potential biomarker of subclinical cardiac remodeling.IL-6 showed stronger correlations with echocardiographic remodeling markers compared with TNF-α and may warrant further investigation as a potential biomarker in this setting.