[The hemodiafiltration with infusion of acetate-free dialysis fluid can modify the inflammatory response in patients "high responders" to inflammatory stimuli?].
OBJECTIVE
This study aimed to verify the effects of paired hemodiafiltration on-line (PHF-AF) on inflammation in patients who were "high responders" to inflammatory stimuli: elevated C-reactive protein (CRP), genetic polymorphisms influencing a low transcription for interleukin-10 (IL-10) and a high transcription for IFN-gamma.


METHODS
Ten patients selected as high responders for IFN-gamma and low responders for IL-10 were included in a crossover study to compare PHF-AF and standard bicarbonate hemodialysis (BHD). At study entry and before the start of each dialysis session the following examinations were performed: CRP, albumin, fibrinogen, ferritin, transferrin, prealbumin and serum levels of IL-6, IL-10, IFN-gamma, tumor necrosis factor-alpha (TNF-alpha). After the 1st and 3rd week of the study, the blood samples were also collected after the dialysis session.


RESULTS
. There was a significant reduction in albumin and prealbumin in PHF-AF patients during the study; none of the other parameters were changed in both patient groups. CRP tended to be elevated after dialysis in both PHF-AF and BHD. While IL-6, IL-10 and IFN-gamma were unchanged during the dialysis session, there was a significant variation in TNF-alpha levels, which were increased in BHD (from 10.9 +/- 3.1 to 14.7 +/- 4.1 pg/mL; p=0.004) and reduced in PHF-AF (from 11.9 +/-2.8 to 6.3 +/- 2.2 pg/mL; p=0.0004).


CONCLUSIONS
Although the cytokine levels were unchanged during the study in both BHD and PHF-AF, the modification of TNF-alpha during the dialysis session was considered as inflammatory significance.
Savoldi
S
S
S.C. di Nefrologia e Dialisi, Università e Ospedali Riuniti, Trieste. ssilvana@tin.it
Sereni
L
L
Bertok
S
S
Ianche
M
M
Bianco
F
F
Marega
A
A
Vianello
S
S
Zanchi
R
R
Klein
P
P
Cicinato
P
P
Pacor
G
G
Gennari
M
M
Bosutti
A
A
Biolo
G
G
Amoroso
A
A
Panzetta
G
G
D000085:Acetates; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D008297:Male
D000085:Acetates; D015312:Hemodialysis Solutions