FRAILTY INFLAMMATORY MARKERS AND MORTALITY AMONG WHITE AND AFRICAN AMERICAN PATIENTS WITH END STAGE RENAL DISEASE

摘要

Although frailty is common among white and African American (AA) ESRD patients, the role of frailty and inflammatory markers on mortality remains unclear. We studied 1,975 ESRD patients (11/1/09-2/28/17) in a multi-center study of frailty and mortality. Serum inflammatory markers (interleukin-6 [IL-6], soluble tumor necrosis factor α receptor-1 [sTNFR1], and C-reactive protein [CRP]) were analyzed in 605 of these participants; we calculated the inflammatory index (IL-6 and sTNFR1). White candidates with elevated inflammatory markers were more likely to be frail (Ps for interaction all<0.05). Frailty (aHR=2.19, 95%CI:1.26–3.79), IL-6 (aHR=2.13, 95%CI:1.41–3.22), sTNFR1 (aHR=1.70, 95%CI:1.12–2.59), CRP (aHR=1.68, 95%CI:1.06–2.67), and the inflammatory index (aHR=2.09, 95%CI:1.38–3.16) were associated with increased mortality risk. However, CRP was a risk factor for waitlist mortality among white patients (aHR=2.76, 95%CI:1.32–6.79) but not AA patients (aHR=1.08, 95%CI:0.62–1.86) (P for interaction=0.04). Frailty and markers of inflammation were associated with increased mortality risk but there were differential effects of CRP by race.