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Neopterin levels in long-term hemodialysis
D Fuchs1, A Hausen, G Reibnegger
1Institute of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.
Clinical Nephrology
|October 1, 1988
Summary
Long-term hemodialysis patients show increased immune activation, indicated by higher neopterin levels. This immune activation is linked to the duration of dialysis treatment, particularly for those on dialysis over one year.
Area of Science:
- Immunology
- Nephrology
- Biochemistry
Background:
- Neopterin is a biomarker for cellular immune activation, produced by macrophages stimulated by interferon-gamma.
- Patients undergoing long-term hemodialysis may experience altered immune system function.
Purpose of the Study:
- To quantify neopterin and creatinine levels in hemodialysis patients.
- To assess the relationship between hemodialysis treatment and the level of in vivo cellular immune activation.
- To investigate the impact of dialysis fluid composition and duration on immune markers.
Main Methods:
- Serum and exchange buffer samples were collected from 20 long-term hemodialysis patients before, during, and after treatment.
- Concentrations of neopterin and creatinine were measured using established quantification techniques.
- Statistical analysis was performed to correlate neopterin levels with dialysis duration and buffer type.
Main Results:
- All studied hemodialysis patients exhibited significantly elevated serum neopterin and neopterin/creatinine ratios.
- No significant difference in neopterin levels was observed between patients treated with acetate versus hydrogencarbonate exchange fluids.
- A positive correlation was found between the duration of hemodialysis and increased neopterin concentrations, with higher immune activation in patients on dialysis for over one year.
Conclusions:
- Long-term hemodialysis is associated with a state of enhanced cellular immune activation.
- The duration of hemodialysis, rather than the type of exchange fluid, appears to be a key factor in elevated neopterin levels.
- This heightened immune activation in dialysis patients may contribute to conditions like accelerated Human Immunodeficiency Virus (HIV) progression.