Inflammatory Response to Sorbent Hemodialysis

Laura Rosales, Stephan Thijssen, Anja Kruse, Murat Hairy Sipahioglu, Padam Hirachan, Jochen G Raimann, Viktoriya Kuntsevich, Mary Carter, Nathan W Levin, Peter Kotanko, Laura Rosales, Stephan Thijssen, Anja Kruse, Murat Hairy Sipahioglu, Padam Hirachan, Jochen G Raimann, Viktoriya Kuntsevich, Mary Carter, Nathan W Levin, Peter Kotanko

Abstract

Inflammation is common and associated with morbidity and mortality in hemodialysis (HD) patients. Exposure to endotoxin contained in the dialysate may trigger inflammation. Dialysate volume is substantially reduced in sorbent HD compared with standard single-pass dialysis. In this prospective study (Clinicaltrials.gov, number: NCT00788905), we compared the inflammatory response to single-pass and sorbent HD. Patients receiving single-pass HD were studied during 1 week of sorbent HD (Allient system; Renal Solutions, Warrendale, PA) and 1 week of single-pass HD. Patients were dialyzed using high-flux polysulfone dialyzers. Midweek pre- and post-HD serum levels of high-sensitivity C-reactive protein, interleukin (IL)-1β, IL-6, IL-10, interferon gamma, tumor necrosis factor alpha (TNF-α), and eotaxin were determined and their intradialytic change corrected for hemoconcentration during single-pass HD and sorbent HD compared by paired t-test. We enrolled 18 patients, nine completed the study. Although TNF-α decreased during both single-pass and sorbent HD (p < 0.001), none of the other biomarkers changed significantly during HD. We observed no difference between single-pass and sorbent HD. For the markers investigated in this study, there was no difference in the acute intradialytic inflammatory response to single-pass or sorbent HD.

Conflict of interest statement

Disclosure: Mary Carter, Peter Kotanko, and Nathan W. Levin hold stocks in Fresenius Medical Care.

Figures

Figure 1.
Figure 1.
Study flow chart. BUN, blood urea nitrogen; HD, hemodialysis.
Figure 2.
Figure 2.
Intradialytic changes of biomarkers of inflammation during single-pass hemodialysis (red), sorbent hemodialysis (green), and the difference between these changes (blue). The data indicate means and 95% confidence intervals. hs-CRP: high-sensitivity C-reactive protein.

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Source: PubMed

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