Inflammatory markers in end-stage renal disease patients on haemodialysis

Phebe Lotfy Abdel-Messeih, Manal Mohamed Alkady, Neveen Mostafa Nosseir, Mohamed Said Tawfik, Phebe Lotfy Abdel-Messeih, Manal Mohamed Alkady, Neveen Mostafa Nosseir, Mohamed Said Tawfik

Abstract

Background: CXC chemokine ligand 16 (CXCL16) is an inflammatory chemokine that mediates renal infiltration of macrophages and activated T cells. Aim: To investigate serum levels of CXCL16 in patients undergoing hemodialysis and their correlation with other inflammatory markers such as C-reactive protein (CRP) and intact parathyroid hormone (iPTH).

Methods: The study included 40 hemodialysis patients (22 males) and 40 age and gender-matched controls (24 males). Fasting blood sugar (FBS), urea, creatinine, calcium and inorganic phosphorous were assayed in participants using routine methods, glycosylated hemoglobin (HbA1c) by quantitative chromatographic spectrophotometry, iPTH by chemiluminescent microparticle immunoassay, CRP by nephelometry and CXCL16 by ELISA technique.

Results: Serum CXCL16, CRP, PTH, FBS, HbA1c, phosphorus, urea, and creatinine levels were significantly higher in hemodialysis patients compared to controls (p<0.00001). No statistically significant differences were observed between patients and controls for calcium. Serum CXCL16 levels correlated positively with CRP (r=0.956, p<0.00001) and iPTH (r=-0.403, p<0.001). Hemodialysis patients (diabetics or hypertensives) had significantly higher CXCL16 levels compared to non-diabetics or non-hypertensives.

Conclusions: High levels of serum CXCL16, CRP and iPTH reflect the inflammatory status of hemodialysis patients and help avoid complications. Serum CXCL16 could be used as a biomarker together with CRP in these patients.

Keywords: CRP; CXCL16; ESRD; iPTH.

Conflict of interest statement

Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article.

2020 Phebe Lotfy Abdel-Messeih, Manal Mohamed Alkady, Neveen Mostafa Nosseir, Mohamed Said Tawfik, published by CEON/CEES.

Figures

Figure 1. Correlation between CXC chemokine ligand…
Figure 1. Correlation between CXC chemokine ligand - 16 (CXCL-16) and C-reactive protein (CRP) in end stage renal disease (ESRD) patients on hemodialysis.
Figure 2. Correlation between CXC chemokine ligand…
Figure 2. Correlation between CXC chemokine ligand 16 (CXCL16) and intact parathyroid hormone (iPTH) in end stage renal disease (ESRD) patients on hemodialysis.
Figure 3. Serum CXC chemokine ligand 16…
Figure 3. Serum CXC chemokine ligand 16 (CXCL16) in end stage renal disease (ESRD) patients on hemo dialysis with and without diabetes mellitus (DM).
Figure 4. Serum CXC chemokine ligand 16…
Figure 4. Serum CXC chemokine ligand 16 (CXCL16) in end stage renal disease (ESRD) patients on hemo dialysis with and without hypertension.

References

    1. National Kidney Foundation K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 suppl 1):S1.
    1. Grill A K, Brimble S. Approach to the detection and management of chronic kidney disease: What primary care providers need to know. Can Fam Physician. 2018;64(10):728.
    1. GBD 2013 Mortality and Causes of Death Collaborators Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–71.
    1. Ortiz A, Covic A, Fliser D, Fouque D, Goldsmith D, Kanbay M, Mallamaci F, Massy Z A, Rossignol P, Vanholder R, Wiecek A, Zoccali C, London G M. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet. 2014;383(9931):1831. doi: 10.1016/s0140-6736(14)60384-6.
    1. Izquierdo M C, Martin-Cleary C, Fernandez-Fernandez B, Elewa U, Sanchez-Niño M D, Carrero J J, Ortiz A. CXCL16 in kidney and cardiovascular injury. Cytokine Growth Factor Rev. 2014;25(3):317. doi: 10.1016/j.cytogfr.2014.04.002.
    1. Aslanian A M, Charo I F. Targeted disruption of the scavenger receptor and chemokine CXCL16 accelerates atherosclerosis. Circulation. 2006;114(6):583. doi: 10.1161/circulationaha.105.540583.
    1. Shimaoka T, Kume N, Minami M, Hayashida K, Kataoka H, Kita T, Yonehara S. Molecular cloning of a novel scavenger receptor for oxidized low density lipoprotein, SR-PSOX, on macrophages. J Biol Chem. 2000;275(52):40663. doi: 10.1074/jbc.c000761200.
    1. Wu T, Xie C, Wang H W, Zhou X J, Schwartz N, Calixto S, Mackay M, Aranow C, Putterman C, Mohan C. Elevated urinary VCAM-1, P-selectin, soluble TNF receptor-1, and CXC chemokine ligand 16 in multiple murine lupus strains and human lupus nephritis. J Immunol. 2007;179(10):7166. doi: 10.4049/jimmunol.179.10.7166.
    1. Ležaić V. Serum and urinary biomarkers determination and their significance in diagnosis of kidney diseases J Med Biochem. 2010;29(4):288. doi: 10.2478/v10011-010-0046-3.
    1. Panichi V, Maggiore U, Taccola D, Migliori M, Rizza G M, Consani C, Bertini A, Sposini S, Perez-Garcia R, Rindi P, Palla R, Tetta C. Interleukin-6 is a stronger predictor of total and cardiovascular mortality than C-reactive protein in haemodialysis patients. Nephrol Dial Transplant. 2004;19(5):1154. doi: 10.1093/ndt/gfh052.
    1. Jerin A, Mosa O F, Kališnik J M, Žibert J, Skitek M. Serum Klotho as a marker for early diagnosis of acute kidney injury after cardiac surgery. J Med Biochem. 2020;39(2):133. doi: 10.2478/jomb-2019-0024.
    1. de Francisco A L. Secondary hyperparathyroidism: Review of the disease and its treatment. Clin Ther. 2004;26(12):1976. doi: 10.1016/j.clinthera.2004.12.011.
    1. Mitnick M A, Grey A, Masiukiewicz U, Bartkiewicz M, Rios-Velez L, Friedman S, Xu L, Horowitz M C, Insogna K. Parathyroid hormone induces hepatic production of bioactive interleukin-6 and its soluble receptor. Am J Physiol Endocrinol Metab. 2001;280(3):E405. doi: 10.1152/ajpendo.2001.280.3.e405.
    1. Grey A, Mitnick M A, Shapses S, Ellison A, Gundberg C, Insogna K. Circulating levels of interleukin-6 and tumor necrosis factor-alpha are elevated in primary hyperparathyroidism and correlate with markers of bone resorption: A clinical research center study. J Clin Endocrinol Metab. 1996;81(10):3450. doi: 10.1210/jcem.81.10.8855783.
    1. Emam A A, Mousa S G, Ahmed K Y, Al-Azab A A. Inflammatory biomarkers in patients with asymptomatic primary hyperparathyroidism. Med Princ Pract. 2012;21:249–53.
    1. Roberts L, Jones T W, Fournier P A. Exercise training and glycemic control in adolescents with poorly controlled type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2002;15(5):621. doi: 10.1515/jpem.2002.15.5.621.
    1. Sproston N R, Ashworth J J. Role of C-reactive protein at sites of inflammation and infection. Front Immunol. 2018;9:754–754. doi: 10.3389/fimmu.2018.00754.
    1. Kritmetapak K, Pongchaiyakul C. Parathyroid hormone measurement in chronic kidney disease: From basics to clinical implications Int J Nephrol. 2019;2019(1-9) doi: 10.1155/2019/5496710.
    1. Heidari B. C-reactive protein and other markers of inflammation in hemodialysis patients. Caspian J Intern Med. 2013;4(1):611.
    1. Nadeem M, Stephen L, Schubert C, Davids M R. Association between periodontitis and systemic inflammation in patients with end-stage renal disease. SADJ. 2009;64:470–473.
    1. Sardenberg C, Suassuna P, Andreoli M C C, Watanabe R, Dalboni M A, Manfredi S R, dos Santos O P, Kallas E G, Draibe S A, Cendoroglo M. Effects of uraemia and dialysis modality on polymorphonuclear cell apoptosis and function. Nephrol Dial Transplant. 2006;21(1):160. doi: 10.1093/ndt/gfi095.
    1. Dinarello C A. Proinflammatory cytokines. Chest. 2000;118(2):503. doi: 10.1378/chest.118.2.503.
    1. Baragetti I, el Essawy B, Fiorina P. Targeting immunity in end-stage renal disease. Am J Nephrol. 2017;45(4):310. doi: 10.1159/000458768.
    1. Cobo G, Lindholm B, Stenvinkel P. Chronic inflammation in end-stage renal disease and dialysis. Nephrol Dial Transplant. 2018;33(suppl_3):iii35. doi: 10.1093/ndt/gfy175.
    1. Zimmermann O, Li K, Zaczkiewicz M, Graf M, Liu Z, Torzewski J. C-reactive protein in human atherogenesis: Facts and fiction Mediators Inflamm. 2014;2014:1–6. doi: 10.1155/2014/561428.
    1. Yuen N K, Ananthakrishnan S, Campbell M J. Hyperparathyroidism of renal disease Perm J. 2016;20(3):15. doi: 10.7812/tpp/15-127.
    1. Cheng S, Lee J, Liu T, Yang T, Chen H, Wu C, Liu C P. Parathyroidectomy improves symptomatology and quality of life in patients with secondary hyperparathyroidism. Surgery. 2014;155(2):320. doi: 10.1016/j.surg.2013.08.013.
    1. Elewa U, Sanchez-Niño M D, Mahillo-Fernández I, Martin-Cleary C, Belen S A, Perez-Gomez M V, Fernandez-Fernandez B, Ortiz A. Circulating CXCL16 in diabetic kidney disease. Kidney Blood Press Res. 2016;41(5):663. doi: 10.1159/000447935.
    1. Nazari A D, Sardoo A M, Fard E T, Khorramdelazad H, Hassanshahi G, Esmaeili N A. Plasma CXCL16 level is associated with cardiovascular disease in Iranian hemodialysis patients Biomedical and Pharmacology Journal. 2017;10(1):01. doi: 10.13005/bpj/1074.
    1. Hu Z B, Chen Y, Gong Y X, Gao M, Zhang Y, Wang G H, Tang R N, Liu H, Liu B C, Ma K L. Activation of the CXCL16/CXCR6 pathway by inflammation contributes to atherosclerosis in patients with end-stage renal disease. Int J Med Sci. 2016;13(11):858. doi: 10.7150/ijms.16724.
    1. Unal H U, Kurt Y G, Gok M, Cetinkaya H, Karaman M, Eyileten T, Vural A, Oguz Y, Yilmaz M I. The importance of serum CXCL-16 levels in patients with grade III-V chronic kidney disease Turkish Nephrology Dialysis Transplantation. 2014;23(3):234. doi: 10.5262/tndt.2014.1003.10.
    1. Lin Z, Gong Q, Zhou Z, Zhang W, Liao S, Liu Y, Yan X, Pan X, Lin S, Li X. Increased plasma CXCL16 levels in patients with chronic kidney diseases. Eur J Clin Invest. 2011;41(8):836. doi: 10.1111/j.1365-2362.2011.02473.x.
    1. Lv Y, Hou X, Ti Y, Bu P. Associations of CXCL16/CXCR6 with carotid atherosclerosis in patients with metabolic syndrome. Clin Nutr. 2013;32(5):849. doi: 10.1016/j.clnu.2013.01.008.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren