[Inflammatory status in patients with end-stage renal disease: role of monocyte activation].
OBJECTIVE
To study the association of monocyte activation and the inflammatory status in patients with end-stage renal disease (ESRD).


METHODS
A total of 166 ESRD patients were recruited in the study, including 63 patients with pre-dialysis chronic renal failure (CRF), 16 undergoing continuous ambulatory peritoneal dialysis (CAPD) and 87 stable hemodialysis (HD) patients. Monocyte activation markers including plasma neopterin, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and plasma levels of acute phase proteins (APP) such as C-reactive protein (CRP) and serum amyloid A (SAA) were monitored using enzyme-linked immunosorbent assay (ELISA) kits.


RESULTS
The levels of neopterin, TNF-alpha, IL-1beta, CRP and SAA significantly increased in ESRD patients as compared with the normal controls (P<0.05 ). CRP and SAA in HD patients were higher than those in non-dialysis patients (P<0.05). The levels of CRP was closely correlated with neopterin, TNF-alpha and IL-1beta(r=0.287, 0.314, 0.262, P<0.05, respectively), and SAA with neopterin (r=0.306, P<0.05). These correlations remained significant after the values were adjusted for creatinine clearance in non-dialysis patients. Plasma contents of TNF-alpha, IL-1beta, CRP and SAA were significantly elevated after a single hemodialysis session (P<0.05).


CONCLUSIONS
Chronic inflammation occurs in patients with ESRD, which might be aggravated by hemodialysis. Activation of the monocytes might be involved in the pathogenesis of inflammation in uremia.
Liang
Min
M
Department of Nephrology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Wang
Li
L
Hou
Fan-fan
FF
Liu
Jun
J
Liu
Zhi-qiang
ZQ
Tian
Jian-wei
JW
D000209:Acute-Phase Proteins / Q000032:analysis; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000502:physiology*; D019798:Neopterin / Q000097:blood; D006435:Renal Dialysis; D000685:Serum Amyloid A Protein / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000209:Acute-Phase Proteins; D000685:Serum Amyloid A Protein; D014409:Tumor Necrosis Factor-alpha; D019798:Neopterin; D002097:C-Reactive Protein