title: [The hemodiafiltration with infusion of acetate-free dialysis fluid can modify the inflammatory response in patients "high responders" to inflammatory stimuli?].
abstract: 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.
authors.affiliation: S.C. di Nefrologia e Dialisi, Università e Ospedali Riuniti, Trieste. ssilvana@tin.it
authors.forename: S
authors.initials: S
authors.lastname: Savoldi
authors.forename: L
authors.initials: L
authors.lastname: Sereni
authors.forename: S
authors.initials: S
authors.lastname: Bertok
authors.forename: M
authors.initials: M
authors.lastname: Ianche
authors.forename: F
authors.initials: F
authors.lastname: Bianco
authors.forename: A
authors.initials: A
authors.lastname: Marega
authors.forename: S
authors.initials: S
authors.lastname: Vianello
authors.forename: R
authors.initials: R
authors.lastname: Zanchi
authors.forename: P
authors.initials: P
authors.lastname: Klein
authors.forename: P
authors.initials: P
authors.lastname: Cicinato
authors.forename: G
authors.initials: G
authors.lastname: Pacor
authors.forename: M
authors.initials: M
authors.lastname: Gennari
authors.forename: A
authors.initials: A
authors.lastname: Bosutti
authors.forename: G
authors.initials: G
authors.lastname: Biolo
authors.forename: A
authors.initials: A
authors.lastname: Amoroso
authors.forename: G
authors.initials: G
authors.lastname: Panzetta
mesh_terms: 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
chemical_list: D000085:Acetates; D015312:Hemodialysis Solutions