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Inflammatory signals associated with hemodialysis
Kayser Caglar1, Youming Peng, Lara B Pupim
1Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Avenue South & Garland, S-3223 MCN Nashville, TN 37232-2372, USA.
Kidney International
|September 18, 2002
Summary
Hemodialysis triggers an inflammatory response in patients, evidenced by increased acute-phase proteins and interleukin-6. This inflammation is most pronounced in the two hours following the dialysis procedure.
Area of Science:
- Nephrology
- Immunology
- Biochemistry
Background:
- Inflammation is common in chronic hemodialysis patients.
- Hemodialysis involves blood-cell contact with artificial surfaces, potentially inducing inflammation.
- Previous studies lacked clear evidence linking hemodialysis to inflammation markers.
Purpose of the Study:
- To investigate the impact of hemodialysis on inflammation.
- To assess the induction of interleukin-6 (IL-6) production.
- To measure the fractional synthetic rates (FSR) of albumin and fibrinogen.
Main Methods:
- Nine patients undergoing hemodialysis were studied.
- Primed-constant infusion of l-(l-13C) leucine was used.
- IL-6 levels and FSR of albumin and fibrinogen were measured pre-dialysis, during, and post-dialysis.
Main Results:
- Albumin and fibrinogen FSR significantly increased during hemodialysis (64% and 34%, respectively).
- IL-6 levels modestly increased during hemodialysis (14%) but rose significantly post-dialysis (68%).
- Fibrinogen FSR further increased post-dialysis, while albumin FSR stabilized.
Conclusions:
- Hemodialysis demonstrably induces an inflammatory response.
- The inflammatory response is most significant in the two hours after hemodialysis.
- This study provides clear evidence of hemodialysis-induced inflammation.