title: On-line hemodiafiltration reduces the proinflammatory CD14+CD16+ monocyte-derived dendritic cells: A prospective, crossover study.
abstract: It is not known whether high convective transport may have a role in modulating the chronic inflammation of hemodialysis (HD) patients. The aim of this study was to evaluate the effect of on-line hemodiafiltration (OL-HDF) on proinflammatory peripheral monocytes: Percentage of CD14+CD16+ cells and their telomere length and spontaneous or bacterial DNA-induced production of cytokines (TNF-alpha and IL-6). In a prospective, crossover study, 31 patients who were on high-flux HD (HF-HD) were evaluated. Patients underwent the following sequence of treatments (4 mo each): HF-HD (basal), OL-HDF (period 1), HF-HD (period 2), OL-HDF (period 3), and HF-HD (period 4). The dialysis characteristics were similar in the two modalities; the only difference was a higher convective transport in the OL-HDF than in the HF-HD. All patients who were on OL-HDF periods showed a significantly lower number of CD14+CD16+ cells than on HF-HD (18.5 +/- 2.3 basal versus 13.6 +/- 2.9 period 1 and 13.9 +/- 2.3 period 3; P = 0.001). By contrast, HF-HD restored the number of CD14+CD16+ cells to the basal values (19.2 +/- 2.8 and 18.6 +/- 1.4, periods 2 and 4, respectively; NS). During OL-HDF periods, the reduction of CD14+CD16+ was paralleled by a decreased number of short telomere cells. Spontaneous or bacterial DNA-induced production of cytokines (TNF-alpha and IL-6) was increased in HF-HD as compared with OL-HDF. In conclusion, these results demonstrate that as compared with HF-HD, OL-HDF markedly reduces the number of proinflammatory CD14+CD16+ cells and the production of TNF-alpha and IL-6. Future studies are needed to assess the possible therapeutic effect of convective transport on chronic inflammation that is associated with HD.
authors.affiliation: Unidad de Investigación, Servicio de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Julia
authors.initials: J
authors.lastname: Carracedo
authors.forename: Ana
authors.initials: A
authors.lastname: Merino
authors.forename: Sonia
authors.initials: S
authors.lastname: Nogueras
authors.forename: Diana
authors.initials: D
authors.lastname: Carretero
authors.forename: Isabel
authors.initials: I
authors.lastname: Berdud
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramírez
authors.forename: Ciro
authors.initials: C
authors.lastname: Tetta
authors.forename: Mariano
authors.initials: M
authors.lastname: Rodríguez
authors.forename: Alejandro
authors.initials: A
authors.lastname: Martín-Malo
authors.forename: Pedro
authors.initials: P
authors.lastname: Aljama
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000276:immunology*; D002478:Cells, Cultured; D018592:Cross-Over Studies; D016207:Cytokines / Q000032:analysis; D003713:Dendritic Cells / Q000276:immunology*; D005260:Female; D017583:Hemodiafiltration / Q000295:instrumentation / Q000379:methods; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D009862:Online Systems / Q000295:instrumentation; D011446:Prospective Studies
chemical_list: D015703:Antigens, CD; D016207:Cytokines; D018950:Lipopolysaccharide Receptors