The neutrophil function of uremic patients treated by hemodialysis or CAPD

The phagocytic, bactericidal and chemotactic function of blood neutrophils in uremic patients treated either by CAPD or hemodialysis was assessed in vitro. The phagocytosis was normal in 11 patients on CAPD treatment while it was significantly impaired in 13 patients on maintenance hemodialysis (HD) treatment. In addition the chemotactic function of neutrophils seemed to be better on CAPD treatment, when heat-inactivated serum, zymosan or casein were used as chemoattractants, but the difference was significant only with heat-inactivated serum. In contrast the chemotactic response to Staphylococcus aureus was better in patients on HD treatment. The intracellular killing of bacteria was normal in both patient groups. The more stable metabolic control of acid-base and electrolyte balance and the better clearance of middle molecules could explain the better performance of uremic neutrophils in the patients on CAPD treatment.