title: Role of the hemodialysis vascular access type in inflammation status and monocyte activation.
abstract: OBJECTIVE
  The aim of this study was to ascertain the role of different vascular access types in inflammatory status, monocyte activation, and senescence in hemodialysis patients.
  
  
  METHODS
  We recruited 126 hemodialysis patients, including 51 with arterovenous fistula (AVF), 32 with arterovenous graft (AVG), and 43 with tunneled cuffed catheters (TCC). In dialysis patients enrolled in the study and in a control group of 40 healthy subjects, we measured the serum levels of albumin, CRP, IL-6, and TNF-a, the expression of CD14, CD44, and CD32 on monocyte surface, and the percentage of monocytes exhibiting a senescent phenotype (CD14+CD32+).
  
  
  RESULTS
  The patients with AVG compared to those with AVF had: a) higher levels of CRP and TNF-a; b) increased expression of CD14 and CD32 on monocyte surface, with no difference in CD44 expression; c) no difference in the percentage of CD14+CD32+ monocytes. In the comparison of TCC vs. AVF group, we observed significantly higher values of: a) circulating inflammatory markers (CRP, IL-6, TNF-a); b) monocyte surface expression of cellular activation markers (CD14, CD44 and CD32); c) relative count of CD14+CD32+ monocytes. When comparing TCC vs. AVG group, we found: a) no difference in serum levels of CRP, IL-6, and TNF-a; b) no difference in the expression of CD14, CD44, and CD32 on monocyte surface; c) no difference in the percentage of CD14+CD32+ monocytes.
  
  
  CONCLUSIONS
  These results suggest that the use of AVG and TCC for dialysis vascular access is associated with serological and cellular indexes of inflammatory reaction, also resulting in a higher degree of monocyte activation and senescence.
authors: Nephrology, Dialysis and Renal Transplant Unit, S Orsola University Hospital, Bologna, Italy.
authors: Luigi
authors: L
authors: Colì
authors: Gabriele
authors: G
authors: Donati
authors: Maria L
authors: ML
authors: Cappuccilli
authors: Giuseppe
authors: G
authors: Cianciolo
authors: Giorgia
authors: G
authors: Comai
authors: Vania
authors: V
authors: Cuna
authors: Elisa
authors: E
authors: Carretta
authors: Gaetano
authors: G
authors: La Manna
authors: Sergio
authors: S
authors: Stefoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016922:Cellular Senescence; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000097:blood; D007249:Inflammation / Q000276:immunology*; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007558:Italy; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D010641:Phenotype; D017452:Receptors, IgG / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; C497483:CD44 protein, human; D018960:Hyaluronan Receptors; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D018950:Lipopolysaccharide Receptors; D017452:Receptors, IgG; D012709:Serum Albumin; D014409:Tumor Necrosis Factor-alpha