impact of hemodialysis on interleukin-6 in covid-19-positive patients with chronic kidney disease

Background: in patients with coronavirus disease 2019 (covid-19) with multiple organ involvement, interleukin-6 (il-6) is an important biomarker of the hyperinflammatory immune response, cytokine storm, and fatal outcomes. our research aims to comprehend the value of polysulfone membrane-based hemodialysis (hd), not only in terms of lowering renal load but also in terms of enhancing outcomes by addressing the il-6 levels in patients with chronic kidney disease (ckd) on maintenance hd (mhd). methods: this prospective observational analysis was conducted from july 2020 to january 2022 at a tertiary care hospital in prayagraj, uttar pradesh, india. 181 patients, with a history of ckd on mhd, hospitalized in covid-19 wards were chosen for this study. the usual baseline blood values of the patients were assessed. hd was done on the fresenius polysulfone membrane (fx-8) with an effective surface area of 1.4 m2 and an ultrafiltration coefficient of 12 (ml/h × mmhg). patients' il-6 levels were initially checked before dialysis, and in patients who survived, they were repeated on the day of discharge. data were analyzed using spss software. results: out of a total of 181 patients, 95 were survivors and 86 were non-survivors. most non-survivors were elderly (p < 0.001). the mean neutrophil-lymphocyte ratio (nlr) and d-dimer levels were substantially greater in non-survivors than in survivors (p < 0.001). non-survivors had considerably higher mean serum levels of il-6, creatinine, and urea (p < 0.001). the average number of hd treatments received by survivors was higher (p < 0.001). the relationship between delta il-6 and delta serum creatinine for survivors had a strong positive correlation of r = 0.775 (p < 0.001). conclusion: this study demonstrates that il-6 is a subpar predictor of prognosis in convalescent ckd patients with covid-19. it also emphasizes the use of hd as a life-saving therapeutic strategy that is also cost-effective. lowering il-6 levels can both enhance renal outcomes and calm the cytokine storm.