Assessment of Interleukin-6 in Anemia with Chronic Renal Failure

Abstract

Summary C hronic renal failure is a syndrome characterized by progressive and irreversible deterioration of renal function due to slow destruction of renal parenchyma, eventually terminating in death when sufficient numbers of nephrons have been damaged (Suresh et al., 2012). Renal diseases are associated with a variety of hemopoietic changes. Anemia parallels the degree of renal impairment and its most important cause is failure of renal erythropoietin secretion. Other factors include chronic blood loss, hemolysis and bone marrow suppression by retained uremic factors (Suresh et al., 2012). Anemia is a common problem in patients with CKD, and its incidence increases as glomerular filtration rate declines (Lankhorst and Wish, 2010). There are other factors in chronic kidney disease which contribute to anemia. Acute and chronic inflammatory conditions have a significant impact on anemia in the CKD population by proinflammatory cytokines decreasing EPO production and inducing apoptosis in colony-forming unit-erythroid cells (CFU-E). The early induction of apoptosis in CFU-E cells stops the process of development into RBC. Inflammatory cytokines have also been found to induce the production of hepcidin, a recently discovered peptide generated in the liver, which interferes with RBC production by decreasing iron availability for incorporation into erythroblasts. Red blood cells also have a decreased life span in patients with CKD (Besarab et al., 2009). IL-6 appears to be the major cytokine responsible for the induction of hepcidin production in inflammation. Similarly, inflammatory cytokines such as IL-6 may also contribute to the increase in not only serum hepcidin but also serum ferritin in human diseases (Shah and Agarwal, 2013). This study was conducted on 80 patients of chronic renal failure on haemodailysis and the laboratory finding proved to have anemia. They are collected from renal dialysis unit. The patients were divided into three groups: Group A: included 30 patients ESRD on regular hemodialysis with hemoglobin concentration < 10 gm/dL. Group B: Included 30 patients ESRD on regular hemodialysis with hemoglobin concentration > 10 gm/dL. Group C: Included 20 patients ESRD on regular hemodialysis with hemoglobin concentration > 12 gm/dL.