title: Reduction of pro-inflammatory cytokines through hemodiafiltration.
abstract: BACKGROUND
  Hemodialysis (HD) prolongs the life of the patients with end stage renal disease (ESRD), but the survival rates are still lower than the general population. More than half of ESRD patients died from cardiovascular disease (CVD). Recent studies have revealed that CVD is a consequence of vascular inflammation, and that there are active inflammatory processes in ESRD patients. Reports have indicated that ESRD patients have fewer CVD events and better survival with hemodiafiltration (HDF), but the reasons for this remain unclear. This study attempts to prove that HDF reduces the CVD-related cytokines.
  
  
  METHODS
  Seventeen adult HD outpatients were put on HDF in our hospital from September 2004 to June 2006. We collected plasma samples before and six months after initiation of HDF. The target pro-inflammatory cytokines selected were interleukin-6 (IL-6), interleukin-18 (IL-18), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP).
  
  
  RESULTS
  After six months of HDF, most of the biochemical parameters did not changed. Plasma IL-18 and TNF-alpha are decreased significantly (p < 0.05) but IL-6 and CRP are not.
  
  
  CONCLUSIONS
  IL-18 and INF-alpha decreased significantly after six months of HDF. These cytokines are key factors in atherosclerotic plaque formation and rupture, and a reduction of these inflammatory cytokines in HDF may reduce the CVD incidence and prolong life.
authors.affiliation: Kidney Institute, China Medical University Hospital, Taichung City, Taiwan.
authors.forename: Huey-Liang
authors.initials: HL
authors.lastname: Kuo
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Liu
authors.forename: Ya-Fei
authors.initials: YF
authors.lastname: Yang
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D007249:Inflammation; D020382:Interleukin-18 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D020382:Interleukin-18; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein