Effect of Initiating Dialysis on Inflammatory State and Immune Response in Patients with End-stage Renal Disease.
- Author:
Jae Won LEE
1
;
Hye Won KIM
;
Eun Bum PARK
;
Chang Su BOO
;
Gang Jee KO
;
Sang Kyung JO
;
Won Yong CHO
;
Hyoung Kyu KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea. wonyong@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Inflammation;
Cytokines;
Immunity;
Dialysis
- MeSH:
Adiponectin;
Atherosclerosis;
C-Reactive Protein;
Cytokines;
Dialysis*;
Humans;
Inflammation;
Interleukin-10;
Interleukins;
Kidney Failure, Chronic*;
Malnutrition;
Mortality;
Nutritional Status;
Peritoneal Dialysis, Continuous Ambulatory;
Renal Dialysis;
Renal Insufficiency, Chronic;
Serum Albumin;
Tumor Necrosis Factor-alpha;
Uremia
- From:Korean Journal of Nephrology
2007;26(5):559-566
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: inflammation is a common feature in chronic kidney disease patients, and it could contribute to long-term morbidity and mortality related with malnutrition and atherosclerosis. In this study, we aimed to investigate the effect of initiating dialysis on inflammatory state, nutritional parameter, and immune response in end-stage renal disease (ESRD) patients. METHODS: 57 ESRD patients who initiated hemodialysis (HD, n=31) or continuous ambulatory peritoneal dialysis (CAPD, n=26) were enrolled. Pro-inflammatory cytokine, tumor necrosis factor (TNF)-alpha, and anti-inflammatory cytokines, interleukin (IL)-10 and adiponectin were measured before and 3 months after initiation of dialysis. Inflammatory marker, highly sensitive C-reactive protein (hs-CRP), and nutritional parameter, albumin, were also checked. Lipopolysaccharide (LPS)-stimulated production of TNF-alpha and IL-10 were measured for the evaluation of immune response by external stimuli. RESULTS: As uremia was reduced by initiating dialysis, serum level of TNF-alpha was decreased and adiponectin was increased. These changes were accompanied by the decrease of hs-CRP and the increase of serum albumin. LPS-stimulated cytokines production was increased after initiating dialysis. There differences in these parameters comparing HD and CAPD patients except more increase of serum adiponectin level in CAPD patients. CONCLUSION: Our study demonstrated that initiation of dialysis results in decrease of inflammation, improvement of nutritional status, and restoration of proper immune responsiveness in ESRD patients. These results suggest that correction of uremic milieu through dialysis has beneficial effects. Therefore, initiation of dialysis might have the advantage of improving inflammatory and nutritional status, and correcting immune dysfunction in ESRD patients.
