EVALUATION OF THE BEHAVIOR OF LEVELS OF HMGB1 AND IL6 AS PREDICTORS OF INFECTION, ACUTE KIDNEY INJURY AND MORTALITY IN CIRRHOTIC PATIENTS WITH VARICEAL BLEEDING

Arq Gastroenterol. 2018 Oct-Dec;55(4):338-342. doi: 10.1590/S0004-2803.201800000-75.

Abstract

Background: Gastroesophageal varices and associated bleeding are a major cause of morbidity and mortality in cirrhotic patients.

Objective: To evaluate the potential role of the biomarkers HMGB1 (High Mobility Group Box 1) and IL-6 (Interleukin-6) as predictors of infection, acute kidney injury and mortality in these patients.

Methods: It is a prospective, observational study that included 32 cirrhotic patients with variceal bleeding.

Results: The subjects'mean age was 52±5 years and 20 (62.5%) were male. The average MELD was 17.53±5 and the average MELD-Na was 20.63±6.06. Thirty patients (93.3%) patients were Child-Pugh class B or C. Infection was present in 9 subjects (28.1%), acute kidney injury was present in 6 (18.1%) and 4 (12.5%) patients died. The median serum levels of HMGB1 were 1487 pg/mL (0.1 to 8593.1) and the median serum level of IL-6 was 62.1 pg/mL (0.1 to 1102.4). The serum levels of HMGB1 and IL-6 were significantly higher in patients who developed infection, acute kidney injury and death (P<0.05). The Spearman's correlations for HMGB1 and IL-6 were 0.794 and 0.374 for infection, 0.53 and 0.374 for acute kidney injury and 0.467 and 0.404 for death, respectively.

Conclusion: Serum levels of HMGB1 and IL-6 were higher in patients with the three studied outcomes. HMGB1 serum levels showed a high correlation with infection and a moderate correlation with acute kidney injury and death, while IL-6 showed a moderate correlation with infection and death and a low correlation with acute kidney injury.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / blood*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / mortality
  • Biomarkers / blood
  • Esophageal and Gastric Varices / blood*
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / diagnosis
  • Esophageal and Gastric Varices / mortality
  • Female
  • Gastrointestinal Hemorrhage / blood*
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / mortality
  • HMGB1 Protein / blood*
  • Humans
  • Interleukin-6 / blood*
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / mortality
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies

Substances

  • Biomarkers
  • HMGB1 Protein
  • Interleukin-6