Filtration of Macrophage Migration Inhibitory Factor (MIF) in Patients with End Stage Renal Disease Undergoing Hemodialysis.
BACKGROUND
End stage renal disease (ESRD) patients are characterized by increased morbidity and mortality due to highest prevalence of cardiovascular disease. Macrophage migration inhibitory factor (MIF) is an inflammatory cytokine that controls cellular signaling in human physiology, pathophysiology, and diseases. Increased MIF plasma levels promote vascular inflammation and development of atherosclerosis. We have shown that MIF is associated with vascular dysfunction in ESRD patients. Whether hemodialysis (HD) affects circulating MIF plasma levels is unknown. We here aimed to investigate whether HD influences the circulating MIF pool in ESRD patients.


RESULTS
An observational single-center study was conducted. MIF plasma levels in ESRD patients were assessed before, during, and after a HD session (n = 29). Healthy age-matched volunteers served as controls to compare correlations of MIF plasma levels with inflammatory plasma components (n = 20). MIF removed from the circulating blood pool could be detected in the dialysate and allowed for calculation of totally removed MIF (MIF content in dialysate 219±4 μg/HD-session). MIF plasma levels were markedly decreased 2 hour after initiation of HD (MIF plasma level pre-HD 84.8±6 ng/ml to intra-HD 61.2±5 ng/ml p<0.001) and were replenished already 20 min after termination of HD to basal levels (intra-HD 61.2±5 ng/ml to post-HD 79.8±5 ng/ml, p<0.001).


CONCLUSIONS
MIF is a dialyzable plasma component that is effectively filtrated during HD from the patient blood pool in large amounts. After removal of remarkable amounts of MIF during a single HD session, MIF plasma pool is early reconstituted after termination of HD from unknown sources.
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Peter
P
Luedike
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Christos
C
Rammos
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Julia
J
Pohl
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Martin
M
Heisler
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Matthias
M
Totzeck
DaVita Renal Center, Bismarckstraße 101, 40210 Düsseldorf, Germany.
Werner
W
Kleophas
DaVita Renal Center, Bismarckstraße 101, 40210 Düsseldorf, Germany.
Gerd R
GR
Hetzel
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Malte
M
Kelm
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Ulrike
U
Hendgen-Cotta
University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Tienush
T
Rassaf
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015314:Dialysis Solutions / Q000378:metabolism; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D019746:Intramolecular Oxidoreductases / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood; D006435:Renal Dialysis; D013997:Time Factors
D015314:Dialysis Solutions; D019746:Intramolecular Oxidoreductases; D008263:Macrophage Migration-Inhibitory Factors; C515598:MIF protein, human