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Inflammatory Response to Sorbent Hemodialysis.
Laura Rosales1, Stephan Thijssen, Anja Kruse
1From the *Renal Research Institute, New York, New York; †Mount Sinai Beth Israel, New York, New York; ‡Agarwal Nephrology and Hypertension PC, Columbus, Georgia; §Nephrology, Spitalzentrum, Biel, Switzerland; and ¶Erciyes Medical University, Nephrology, Kayseri, Turkey.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|February 25, 2015
Summary
This study found no significant difference in the acute inflammatory response between single-pass and sorbent hemodialysis (HD). Neither HD method altered key inflammatory biomarkers, suggesting comparable intradialytic inflammation for hemodialysis patients.
Area of Science:
- Nephrology
- Immunology
- Biomedical Engineering
Background:
- Inflammation is a significant complication in hemodialysis (HD) patients, contributing to morbidity and mortality.
- Endotoxin exposure from dialysate is a potential trigger for inflammation during HD.
- Sorbent HD utilizes a reduced dialysate volume compared to standard single-pass HD, potentially impacting inflammatory responses.
Purpose of the Study:
- To prospectively compare the acute intradialytic inflammatory response between single-pass HD and sorbent HD.
- To evaluate changes in specific inflammatory biomarkers during and after both HD modalities.
- To determine if reduced dialysate volume in sorbent HD affects the inflammatory response.
Main Methods:
- Prospective study comparing one week of sorbent HD with one week of single-pass HD in 18 patients undergoing high-flux polysulfone dialysis.
- Serum levels of high-sensitivity C-reactive protein, IL-1β, IL-6, IL-10, interferon gamma, TNF-α, and eotaxin were measured pre- and post-HD.
- Intradialytic changes in biomarkers were corrected for hemoconcentration and compared using paired t-tests.
Main Results:
- Tumor necrosis factor alpha (TNF-α) significantly decreased during both single-pass and sorbent HD (p < 0.001).
- No significant changes were observed in other investigated inflammatory biomarkers (IL-1β, IL-6, IL-10, interferon gamma, eotaxin) during either HD modality.
- No statistically significant difference in the intradialytic inflammatory response was found between single-pass HD and sorbent HD.
Conclusions:
- The acute intradialytic inflammatory response, based on the biomarkers investigated, is similar for both single-pass and sorbent hemodialysis.
- Sorbent HD, despite reduced dialysate volume, does not appear to elicit a different acute inflammatory response compared to standard single-pass HD.
- Further research may be needed to explore long-term inflammatory effects or responses to other biomarkers in sorbent HD.
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