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

J Nephrol. 2013 Mar-Apr;26(2):243-53. doi: 10.5301/jn.5000169. Epub 2012 Jun 8.


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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / immunology
  • Cardiovascular Diseases / mortality
  • Humans
  • Inflammation Mediators / blood*
  • Interleukin-6 / blood*
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / immunology
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Odds Ratio
  • Predictive Value of Tests
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / mortality
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Up-Regulation


  • Biomarkers
  • IL6 protein, human
  • Inflammation Mediators
  • Interleukin-6
  • C-Reactive Protein