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Mediators of Inflammation
Volume 12 (2003), Issue 1, Pages 15-19
http://dx.doi.org/10.1080/0962935031000096935

Acute effect of hemodialysis on serum levels of the proinflammatory cytokines

1Department of Biochemistry and Clinical Biochemistry, Gaziantep University, Medicine Faculty, Şehitkamil Gaziantep, Gaziantep 27310, Turkey
2Department of Nephrology, Gaziantep University, Medicine Faculty, Şehitkamil Gaziantep, Gaziantep 27310, Turkey

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic inflammation is a common feature of end-stage renal disease, which carries a heightened risk of atherosclerosis and other co-morbid conditions. Dialysis treatment per se can bring additional risk factors for inflammation, such as increased risk of local graft and fistula infections, impure dialysate or bio-incompatible membranes. Our study was designed to determine whether a hemodialysis session leads to an acute substantial alteration in the plasma levels of the proinflammatory cytokines interleukin (IL)-6, IL-1β and tumor necrosis factor (TNF)-α, the T-lymphocyte activation factor soluble IL-2 receptor (sIL-2R), and an inflammation mediator and chemotactic granulocyte factor, IL-8, in end-stage renal disease patients receiving chronic intermittent HD. In this study, 21 (12 male/nine female) patients undergoing chronic hemodialysis were enrolled. The acute effect of a hemodialysis session on serum cytokine concentrations was assessed by comparison of pre-hemodialysis and post-hemodialysis determinations. Serum IL-1β, sIL-2R, IL-6, IL-8 and TNF-α levels were determined with chemiluminescence enzyme immunometric assays.

A significant difference was not observed for IL-1β, IL-6, TNF-α, and sIL-2R concentrations in pre-hemodialysis and post-hemodialysis specimens (p>0.05). Serum median (25th-75th percentiles) IL-8 concentration was 69.4 (34.9-110.3) pg/ml before hemodialysis, and decreased to 31.5 (18.0-78.8) pg/ml following hemodialysis (p:0.006). Clearance of IL-8 increased by 0.47±0.08 pg/ml for each unit increase in pre-dialysis IL-8 (p<0.001) and decreased by 5.63±2.59 pg/ml for each unit increase in pre-dialysis urea mmol/l (p<0.05).

In conclusion, the results of our study demonstrate that a hemodialysis session markedly decreases IL-8 concentration, which is significantly affected by pre-dialysis concentrations, indicating that removal of IL-8 is a concentration gradient-dependent action, but does not change the serum levels of IL-1β, sIL-2R, IL-6, and TNF-α, underlining importance of the structural characteristics of the molecules.