Clinical relevance of cytokine production in hemodialysis

Abstract

Clinical relevance of cytokine production in hemodialysis.ates a complex of acute and chronic side effects also Blood-dialyzer interaction in hemodialysis has the potential known as "bioincompatibility phenomena" [4, 5].to activate mononuclear cells leading to the production of Many aspects regarding morbidity and mortality of inflammatory cytokines. The extent of activation is dependent dialysis patients may be related to these cellular events on the dialyzer material used and is considered an index of and, in particular, to the production of cytokines by pebiocompatibility. Cytokines, such as interleukin-1␤ (IL-1␤), tumor necrosis factor-␣ (TNF-␣), and IL-6, may induce an ripheral blood mononuclear cells (PBMCs) [6,7]. Cytoinflammatory state and are believed to play a significant role in kines are a family of pleiotropic polypeptides with a dialysis-related morbidity. The interleukin hypothesis suggests molecular weight ranging from 10 to 45 kD that, prothat the release of proinflammatory cytokines acts as an underduced by different cells in response to inflammatory stimlying pathophysiologic event in hemodialysis-related acute uli, may modulate a variety of functions not only in manifestations, such as fever and hypotension. Nevertheless, a cytokine overproduction may alter sleep pattern in chronic circulating immune cells, but also in mesenchymal, endohemodialyzed patients, thus explaining the presence of sleep thelial, and epithelial cells [8]. There is an increasing disorders in these patients. A potential role of cytokines in body of evidence that the interaction between blood chronic-related morbidity has also been suggested. High levels and dialytic membranes induces the release of several of some inflammatory cytokines are often associated with anemia caused by hyporesponsiveness to erythropoietin. Cytokine cytokines from circulating mononuclear cells, such as production may also play a relevant role in bone remodeling by interleukin-1 (IL-1), IL-6, IL-8, tumor necrosis factor-␣ regulating osteoblast/osteoclast cell functions and parathyroid (TNF-␣), and monocyte chemotactic factor-1 (MCP-1). hormone (PTH). Finally, cytokine release may have a long-The specific action of any of these monocyte-derived term deleterious effect on mortality of uremic patients by altercytokines may be relevant in the pathogenesis of clinical ing immune response and increasing susceptibility to infections. Bioincompatibility of dialytic membranes may also contribute manifestations often observed in end-stage renal disease to malnutrition in dialysis patients by increasing the monocyte (ESRD) patients undergoing chronic hemodialysis [9,10]. release of catabolic cytokines such as TNF-␣ and IL-6. Bioincompatible dialytic treatment may induce an inappropriate monocyte activation and cytokine production, which, in turn, MECHANISMS INVOLVED IN CYTOKINEmay mediate some of the immune and metabolic dysfunction PRODUCTION DURING HEMODIALYSIS associated with hemodialysis. The use of biocompatible dialytic membranes appears to reduce the...

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

“…The present study confirms previous observations that uremic patients on hemodialysis have increased inflammatory activity defined by increased CRP or cytokines (IL-6, TNF-α) (19)(20)(21)(22)(23). Our unselected patient population presented high morbidity compatible with the situation observed in a general hospital.…”

Aging and low-grade inflammation reduce renal function in middle-aged and older adults in Japan and the USA

“…The utility of GFR as a biomarker and its sensitivity to inflammatory physiology has not been considered before in healthy adults. More typically, the clinical research has focused on patient populations already in need of hemodialysis or with chronic renal disease (Gupta et al 2012;Pertosa et al 2000). The ability to assess kidney function via creatinine and other biochemical indices from blood and urine specimens provides a unique tool for evaluating population health and for those interested in discerning the causes of disparities in health.…”

Determination of oxidative stress and cellular inflammation in patients with diabetic nephropathy and non-diabetic nephropathy being administered hemodialysis treatment due to chronic renal failure

“…There exist a lot of studies showing that hemodialysis treatment has caused to the chronic inflammation, and that this inflammation has happened as a reason to the formation of pro-inflammatory cytokines of dialysis membranes, and that, at the same time, there has been a connection between inflammation and cytokine. 37,38 In our study, we looked at the levels of IL-6 and TNF-a to analyze the changes in the levels of cytokine appearing through hemodialysis treatment. When the control group was compared with the patient groups, we observed increase in IL-6 and TNF-a levels of patient groups.…”