Abstract:

Abstract ：Objective ：To estimate the levels of cytokine release (interleukin-6, IL-6) and subsequent production of acute phase proteins (C-reactive protein, CRP and secretory phospholipase A2, sPLA2) in patients with hemodialysis (HD) and investigate whether the HD-induced acute phase reaction depends on the type of membrane or dialysate. Methodology: The levels of IL-6, CRP and sPLA2 levels were assessed in blood samples drawn before, at the end and 24h after the start of HD in ten HD patients. All patients were dialysed on fibrin diacetate (FB) and Polysulphon (PS) dialysers, and 5 patients underwent an additional HD session on FB plus a dialysate filter (FBf). Results: The IL-6 levels in patients with FB and FBf were increased significantly at the end of HD (P<0.05). After 24 h of HD, the IL-6 levels had returned to baseline, while it did not occur during HD with PS. At the end of HD, the IL-6 was significantly greater with FB and FBf devices, than that with PS (P<0.05). The levels of CRP in patients with FB and FBf was increased significant after 24 h of HD, compared with postdialysis values (P<0.05). In addition, the levels of sPLA2 were significantly increased after 24h of HD, compared with that at the end of HD (P<0.05). The IL-6 levels at t180 were significantly correlated with the levels of CRP (r=0.67, P<0.01) and sPLA2 (r=0.52, P<0.05) after 24h of HD. During HD with PS membranes, the CRP or sPLA2values were not significantly changed. Conclusions: In contrast to PS, both FB and FBf elevated serum IL-6 levels at the end of HD, which correlated with increased the levels of CRP and sPLA2 24h later. Therefore, the membrane types, rather than the bacterial quality of the dialysate, were responsible for the induction of the acute phase response during HD.
Key words:

Key words: haemodialysis;acute phase response;C-reactive protein, interleukin-6, secretory phospholipase A2