| Effect of Initiating Dialysis on Inflammatory State and Immune Response in Patients with End-stage Renal Disease |
| Jae-Won Lee, M.D., Hye-Won Kim, M.D., Eun-Bum Park, M.D., Chang-Su Boo, M.D. Gang-Jee Ko, M.D., Sang-Kyung Jo, M.D., Won-Yong Cho, M.D. and Hyoung-Kyu Kim, M.D. |
| Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea |
| 말기신부전 환자에서 투석치료의 시작이 염증상태 및 면역반응에 미치는 영향에 관한 연구 |
| 이재원 김혜원 박은범 부창수 고강지 조상경 조원용 김형규 |
| 고려대학교 의과대학 내과학교실 |
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| Abstract |
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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)-α, 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-α 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-α 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. |
| Key Words:
Inflammation, Cytokines, Immunity, Dia |
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