TABLE 2.

A recent study of common inflammatory factors associated with cardiovascular complications in hemodialysis patients.

Cytokines	Clinical studies related to cardiovascular complications
IL-1	Several animal studies have shown additional clinical benefits to the kidney with IL-1β inhibitors (Assimon et al., 2018)
	A 2017 randomized, double-blind, placebo-controlled trial of more than 10,000 patients with CKD by Ridker et al. showed that the use of a human monoclonal antibody targeting IL-1β was associated with a significant reduction in the recurrence of cardiovascular events in such patients (Kloner, 2020)
IL-6	In a 5-year follow-up study of 45 patients on long-term hemodialysis, Thang et al. demonstrated that IL-6) had a more powerful predictive prognostic significance for cardiovascular disease than CRP in HD patients (Braunwald and Kloner, 1982)
	This was corroborated in a 2015 case study of multiple biomarker levels in 543 ESRD patients, confirming that IL-6 is a strong independent predictor of clinical outcome in patients with CKD (Zuidema and Dellsperger, 2012; Arcari et al., 2021)
	A case study in 2021 evaluated the genetic phenotypic differences in IL-6 and its predictive value for all-cause mortality in 289 ESRD patients and found that the IL6 (−174G > C) (r1800795) polymorphism regulates the inflammatory response in ESRD patients. The CC genotype, a less common IL6 genotype, causes more severe inflammation and suggests a poorer prognosis in ESRD patients (deFilippi et al., 2012)
IL-18	A 2015 study of the prognosis of patients with CKD who had an acute myocardial infarction 1 year earlier concluded that IL18 was a significant predictor of cardiogenic death at 2-year follow-up (Raber et al., 2021a)
CRP	A 2021 study assessing the correlation between dialysis adequacy and inflammation in 536 HD patients using CRP as an indicator of inflammation noted that inadequate dialysis doses may lead to higher levels of inflammation in chronic hemodialysis patients. And high levels of CRP were directly correlated with neutrophil-lymphocyte ratio and serum albumin (Raber et al., 2021b)
sAlb	The relationship between changes in albumin and sAlb and prognosis in patients transitioning from CKD to ESRD stage was studied for the first time in 2019. Patients just transitioning from CKD to ESRD have a high short-term mortality rate, so improving the nutritional status of pre-ESRD patients, including sAlb levels, is important for the prognosis of such patients (Miller-Hodges et al., 2018). lower pre-ESRD sAlb is significantly associated with higher all-cause, cardiovascular and infection-related mortality and hospitalization rates after ESRD (Twerenbold et al., 2018)
	In 2020 Amanda et al. compared sAlb and its prognosis across renal function and found that despite the apparent correlation between sAlb and eGFR, a significant correlation between sAlb and mortality in patients with CKD was observed in multiple subgroups classified by renal function (Kraus et al., 2018). It was also noted that sAlb <4.6 g/dl suggested higher mortality and that maintaining sAlb between 4.6 and 4.8 g/dl may be more beneficial in CKD patients with eGFR <60 ml/min/1.73 m2. Therefore, we suggest that dietary protein intake should be moderate for patients with CKD and that high sAlb should not be the therapeutic goal (Ponikowski et al., 20162016; Arcari et al., 2020)