Abstract: Objective To investigate the levels of serum interleukin-6 (IL-6) and fibroblast growth factor-23 (FGF-23) in hemodialysis patients with chronic renal failure (CRF), and to analyze the relationship between them and protein-energy wasting (PEW). Methods 150 patients with CRF treated in the hospital from August 2018 to August 2021 were selected as the research subjects. All patients received maintenance hemodialysis and were followed up for 24 weeks. According to the occurrence of PEW at the end of follow-up, the patients were divided into occurrence group and non occurrence group; the baseline data questionnaire of patients was designed at admission, and the initial baseline data and laboratory indexes of patients in the two groups were compared; the relationship between the initial serum levels of IL-6 and FGF-23 and pew in hemodialysis patients with CRF was mainly analyzed. Results The incidence of PEW in 150 hemodialysis patients with CRF was 24.67% (37/150); compared with the non occurrence group, the proportion of insufficient dialysis in the occurrence group was higher, and the levels of initial blood creatinine (SCR), C-reactive protein (CRP), IL-6 and FGF-23 were significantly higher, the differences were statistically significant (P<0.05); the results of Logistic regression analysis showed that, insufficient dialysis, high levels of initial SCR, CRP, IL-6 and FGF-23 were the risk factors of PEW in hemodialysis patients with CRF (OR>1, P<0.05); the results from the decision curve showed that, in the range of high risk threshold 0.0~1.0, the combination of serum IL-6 and FGF-23 can predict the net benefit rate of PEW in hemodialysis patients with CRF, which was of clinical significance; by restricted cubic spline analysis, the results showed that, there was a linear dose-response relationship between IL-6 and FGF-23 and PEW in hemodialysis patients with CRF (P<0.05). Conclusion The levels of serum IL-6 and FGF-23 are related to the occurrence of PEW in hemodialysis patients with CRF.

Key words: Chronic renal failure, Hemodialysis, Protein-energy wasting, Interleukin-6, Fibroblast growth factor-23