Inflammatory signals associated with hemodialysis
Inflammatory signals associated with hemodialysis
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DOI：
10.1111/j.1523-1755.2002.kid556.x
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发表时间：
2002-10-01
影响因子：
19.6
通讯作者：
Ikizler, TA
中科院分区：
文献类型：
--
作者：
Caglar, K;Peng, Y;Ikizler, TA
背景。炎症在慢性血液透析患者中非常普遍。由于血液透析涉及血液与“外来”表面的接触，并且在该过程中记录了几种体液和细胞通路的激活，因此血液透析过程被认为是该患者群体中炎症的潜在来源。早期的研究没有提供明确的证据来证明血液透析过程对炎症的潜在影响，如通过细胞因子水平和急性期蛋白产生等炎症标志物进行评估。方法。对 9 名患者进行了研究，在单次血液透析之前 2 小时、期间和之后 2 小时持续灌注 l-(l-(13) C) 亮氨酸。我们评估了血液透析对诱导白细胞介素 6 (IL-6) 产生以及白蛋白和纤维蛋白原（两种著名的急性期蛋白）的分数合成率 (FSR) 的影响。结果。血液透析期间，白蛋白 FSR 和纤维蛋白原 FSR 与基线期间获得的测量值相比显着增加。在此期间，与基线相比，白蛋白和纤维蛋白原 FSR 分别增加了 64% 和 34%（P < 0.05）。虽然血液透析期间 IL-6 浓度的增加幅度不大（14%），但在血液透析后 2 小时结束时，其水平进一步增加（与基线相比高 68%，P < 0.05）。纤维蛋白原 FSR 也在透析后期间进一步增加（与透析期间相比高 17%，与基线相比高 58%），而白蛋白 FSR 在此期间稳定。结论。结果提供了血液透析引起的炎症反应的明确证据。该过程在血液透析后 2 小时内最为明显。
Background. Inflammation is highly prevalent in chronic hemodialysis patients. Because hemodialysis involves the contact of blood with "foreign" surfaces, and the documented activation of several humoral and cellular pathways during the procedure, the hemodialysis procedure has been suggested as a potential source of inflammation in this patient population. Earlier studies did not provide clear-cut evidence of the potential contribution of the hemodialysis procedure to inflammation, as assessed by markers of inflammation such as cytokine levels and acute-phase protein production.Methods. Nine patients were studied using primed-constant infusion of l-(l-(13) C) leucine 2 hours before, during, and 2 hours after a single hemodialysis session. We evaluated the effects of hemodialysis on induction of interleukin-6 (IL-6) production as well as the fractional synthetic rates (FSR) of albumin and fibrinogen, two well-known acute-phase proteins.Results. During hemodialysis, albumin FSR and fibrinogen FSR increased significantly compared to the measurements obtained during baseline period. During this period, albumin and fibrinogen FSR increased 64% and 34%, respectively, compared to baseline (P < 0.05). While the increase in IL-6 concentration was modest during hemodialysis (14%), the levels further increased at the end of the 2-hour post-hemodialysis period (68% higher compared to baseline, P < 0.05). Fibrinogen FSR also demonstrated a further increase during the post-dialysis period (17% higher compared to the intradialytic period and 58% higher compared to baseline), while albumin FSR stabilized during this period.Conclusions. The results provide clear evidence of hemodialysis-induced inflammatory response. The process is most notable during the 2-hour post-hemodialysis period.