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Relationship between phagocyte metabolic function and years of maintenance dialysis
R Vanholder1, W Van Biesen, N Van Lanschoot
1Nephrology Department, University Hospital, Ghent, Belgium.
Abstract:
An index of the activation of NADPH-oxidase in the production of free radicals is CO2 production by the hexose monophosphate shunt of polymorphonuclear cells (PMN). 14CO2 production from glucose-1-C14 was studied as an indicator of PMN function after addition of latex or zymosan to predialysis whole blood, and correlated with the years spent on hemodialysis. In a series of 49 patients, a nadir in PMN metabolic activity, when compared with healthy controls, was reached in a subgroup treated for less than 24 months (n = 24, latex: 109.5 +/- 10.1 vs. 233.7 +/- 11.8; zymosan: 181.9 +/- 18.9 vs. 407.8 +/- 19.3 DPM/10(3) PMNs; p less than 0.01). In patients treated by dialysis for longer than 24 months, PMN metabolic function was significantly better, resulting in partial correction of the defect for both latex and zymosan. Phagocyte CO2 production in response to latex or zymosan correlated significantly with years of dialysis treatment (r = 0.63 and 0.56, respectively, n = 49; p less than 0.001). These findings may have implications for phagocyte reactivity towards infection, bioincompatible dialyzer membranes, and renal transplantation.
Insights
Polymorphonuclear cell (PMN) metabolic activity, a marker of immune function, is reduced in patients undergoing hemodialysis. This immune defect improves with longer dialysis duration, suggesting implications for infection risk and transplant outcomes.
Area of Science:
- Immunology
- Nephrology
- Biochemistry
Background:
- Polymorphonuclear cells (PMNs) play a crucial role in the innate immune system.
- NADPH-oxidase activation, measured by CO2 production from the hexose monophosphate shunt, is a key indicator of PMN metabolic activity.
- Patients undergoing hemodialysis often exhibit altered immune function.
Purpose of the Study:
- To investigate the impact of hemodialysis duration on PMN metabolic activity.
- To assess PMN function as an indicator of immune status in hemodialysis patients.
- To correlate PMN function with the duration of hemodialysis treatment.
Main Methods:
- Measured 14CO2 production from glucose-1-C14 as an index of PMN metabolic activity.
- Stimulated PMNs with latex and zymosan in predialysis whole blood.
- Correlated CO2 production with the number of years patients spent on hemodialysis.
Main Results:
- PMN metabolic activity was significantly lower in patients treated for less than 24 months compared to healthy controls.
- Patients on hemodialysis for longer than 24 months showed partially corrected PMN metabolic function.
- Phagocyte CO2 production positively correlated with the duration of dialysis treatment.
Conclusions:
- Hemodialysis duration influences PMN metabolic function, with longer treatment leading to partial recovery.
- Impaired PMN function in hemodialysis patients may increase susceptibility to infections.
- Findings suggest potential implications for bioincompatibility of dialyzers and renal transplantation outcomes.