Acute effect of hemodialysis on serum levels of the proinflammatory cytokines

Tarakçıoğlu, Mehmet; Erbağcı, Ahmet; Usalan, Celalettin; Deveci, Rukiye; Kocabaş, Ramazan

doi:10.1080/0962935031000096935

Cited by 71 publications

(63 citation statements)

References 21 publications

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“…These data indicate that the enhanced IL-10 level detected in our ESDR patients might be ascribed to the reduced Th1 cytokine TNF-β and decreased inflammatory cytokine IL-8 shown in them. The experiment conducted by Rysz et al [10] showed that the level of IL-8 was lower in HD patients when compared with healthy controls, and Tarakcioglu and colleagues reported IL-8 level of ESRD patients significantly decreased following HD, [21] results that are consistent with our findings of IL-8 alterations in ESRD patients. It is well-known that IL-8 is an inflammation mediator and chemotactic granulocyte factor.…”

Section: Discussionsupporting

confidence: 83%

An Altered Th1/Th2 and Pro-Inflammatory Cytokine Profile in Patients with End-Stage Renal Disease Detected by Suspension Array Technology

et al. 2009

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Background. Patients with end-stage renal disease (ESRD) have an impaired immune response with a dysregulated Th1/Th2 cytokine network. Methods. Twelve ESRD patients on HD were enrolled, and their data of cytokines alterations were divided into pre-and post-HD groups, while data from 12 healthy volunteers served as control. Th1/Th2 and pro-inflammatory cytokines were all measured by suspension array (SA) technology with interleukin (IL)-8 detected simultaneously by ELISA. The correlation between SA technology and ELISA for IL-8 was calculated to compare these two methods. Results. In ESRD patients, as compared with controls, the level of IL-10 increased just prior to HD and IL-1β level decreased only following HD, while the levels of TNF-β and IL-8 decreased both before and after HD. After HD, the levels of IL-1β, IL-4, IL-8, and IL-10 in ESRD patients decreased when compared with those before HD. Statistical analysis by Spearman's rho's test showed significant correlations between SA technology and ELISA on IL-8 (p < 0.001, correlation coefficient 0.946). Conclusions. ESRD patients on HD show an altered cytokine profile with an increase in Th2 cytokine IL-10 and a decrease in Th1 cytokine TNF-β as well as a reduction in pro-inflammatory cytokine IL-8. HD did affect cytokine profile of ESRD patients, decreasing IL-1, IL-4, IL-8, and IL-10. SA technology is useful in the detection of cytokine changes within detection limits of this technology in ESRD patients.

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Section: Discussionsupporting

confidence: 83%

An Altered Th1/Th2 and Pro-Inflammatory Cytokine Profile in Patients with End-Stage Renal Disease Detected by Suspension Array Technology

et al. 2009

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“…In addition, TNF-α levels were not very high even in the patients with other signs of inflammation, as also reported by others (33,34). It is interesting to note that CRP levels after the change of the water purification system correlated closely with the previous CRP levels, suggesting that the patients present a pattern of inflammatory activity dependent on other factors.…”

Section: Discussionsupporting

confidence: 63%

Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients

Thomé

Senger

Garcez

et al. 2005

Braz J Med Biol Res

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Atherosclerosis is a major complication of chronic renal failure. Microinflammation is involved in atherogenesis and is associated with uremia and dialysis. The role of dialysate water contamination in inducing inflammation has been debated. Our aim was to study inflammatory markers in patients on chronic dialysis, before and 3 to 6 months after switching the water purification system from deionization to reverse osmosis. Patients had demographic, clinical and nutritional information collected and blood drawn for determination of albumin, ferritin, C-reactive protein (CRP), interleukin-6, and tumor necrosis factor-α in both situations. Acceptable levels of water purity were less than 200 colony-forming units of bacteria and less than 1 ng/ml of endotoxin. Sixteen patients died. They had higher median CRP (26.6 vs 11.2 mg/dl, P = 0.007) and lower median albumin levels (3.1 vs 3.9 g/l, P < 0.05) compared to the 31 survivors. Eight patients were excluded because of obvious inflammatory conditions. From the 23 remaining patients (mean age ± SD: 51.3 ± 13.9 years), 18 had a decrease in CRP after the water treatment system was changed. Overall, median CRP was lower with reverse osmosis than with deionization (13.2 vs 4.5 mg/l, P = 0.022, N = 23). There was no difference in albumin, cytokines, subjective global evaluation, or clinical and biochemical parameters. In conclusion, uremic patients presented a clinically significant reduction in CRP levels when dialysate water purification system switched from deionization to reverse osmosis. It is possible that better water treatments induce less inflammation and eventually less atherosclerosis in hemodialysis patients.

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“…CRP is specifically recognized as a marker of inflammation and atherosclerosis (30), whereas cTnI levels in HD patients are indicative of subclinical myocardial ischemic injury (5,6,31). We found elevated levels of hsCRP in half of the children on HD and a rise in cTnI levels in 25% of this pediatric cohort, and this may be an indicator of early subclinical atheromatous disease in our patients.…”

Section: Discussionmentioning

confidence: 70%

“…It is also becoming increasingly apparent that HD in itself confers a risk, but the pathophysiologic mechanisms remain elusive. In adults, there is evidence from isotopic (2), electrocardiographic (3,4), biochemical (5,6), and echocardiographic (7,8) studies implicating HD as a source of recurrent subclinical myocardial cell injury, even in the absence of preexisting large-vessel epicardial coronary artery disease (CAD). Using single photon emission computed tomography, we demonstrated acute reductions in global and segmental myocardial blood flow during HD, with matched reversible reductions in segmental contractile function (2), consistent with the definition of myocardial stunning (9).…”

mentioning

confidence: 99%

Pediatric Myocardial Stunning Underscores the Cardiac Toxicity of Conventional Hemodialysis Treatments

Hothi¹,

Rees²,

Marek³

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objective: In adults, hemodialysis (HD)-induced ischemia causes reversible myocardial dysfunction (myocardial stunning) that is progressive with raised attendant mortality. Children share an increased risk for death from a spectrum of uremia-related cardiovascular abnormalities but in the absence of significant classical atheromatous coronary artery disease; therefore, we elected to assess children who were on HD for the occurrence of myocardial stunning to investigate the relative importance of characteristic uremic cardiovascular abnormalities in the development of ischemic cardiac injury.Design, setting, participants, & measurements: We included all single-center long-term HD patients (n ‫؍‬ 12; range 2 to 17 yr), excluding those with structural cardiac disease. Patients underwent conventional thrice-weekly HD for 4 h using high-flux membranes. We measured regional left ventricle wall motion using serial echocardiography (before HD, during HD, and 15 min after HD). Significant stunning was defined as a 20% reduction in regional wall motion (RRWM) in two or more segments and hyperkinesis as an either >20 or >50% increase in shortening fraction (SF).Results: Eleven of 12 patients developed myocardial stunning with varying degrees of compensatory hyperkinesis in unaffected segments, maintaining left ventricular ejection fraction throughout HD. The mean segmental %SF [Overall] and %SF [RRWM] fell during HD (2.19 to 1.77 and 2.72 to 1.37, respectively). Intradialytic BP reduction was significantly associated with mean segmental %SF [RRWM] .Conclusions: Children who receive conventional HD experience myocardial stunning. These data, in combination with previous adult studies of intradialytic myocardial blood flow, suggest a characteristic cardiovascular phenotype in HD patients that predisposes to significant demand ischemia.

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Acute effect of hemodialysis on serum levels of the proinflammatory cytokines

Cited by 71 publications

References 21 publications

An Altered Th1/Th2 and Pro-Inflammatory Cytokine Profile in Patients with End-Stage Renal Disease Detected by Suspension Array Technology

An Altered Th1/Th2 and Pro-Inflammatory Cytokine Profile in Patients with End-Stage Renal Disease Detected by Suspension Array Technology

Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients

Pediatric Myocardial Stunning Underscores the Cardiac Toxicity of Conventional Hemodialysis Treatments

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