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- Yamamoto, T., et al.
(author)
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Changes in circulating biomarkers during a single hemodialysis session
- 2013
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In: Hemodialysis International. - : Wiley. - 1492-7535 .- 1542-4758. ; 17:1, s. 59-66
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Journal article (peer-reviewed)abstract
- The hemodialysis (HD) procedure induces an inflammatory response potentially contributing to cardiovascular disease. Here we investigated the acute impact of HD on circulating biomarkers. Circulating biomarkers (small solutes, middle molecular-sized peptides, and proteins) related to inflammation, oxidative stress, and vascular calcification (VC) were measured before and after a single session of HD in 45 clinically stable patients. Concentrations were corrected for ultrafiltration-induced hemoconcentration. Among vascular calcification-related biomarkers, osteoprotegerin and fetuin-A remained unchanged while fibroblast growth factor-23 (FGF23) decreased by -19%. Changes of FGF23 and changes of phosphate correlated (ρ=0.61, P<0.001). While C-reactive protein did not change, interleukin-6 (IL-6) increased by 14% and pentraxin 3 (PTX3) increased by 45%. IL-6 and PTX3 appear to be valid biomarkers of the intradialytic inflammatory response. VC-related markers were in general not affected by the single HD session; however, the observed correlation between acute changes of FGF-23 and phosphate during HD warrants further studies.
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- Nascimento, MM, et al.
(author)
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Effect of oral N-acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: a placebo-controlled study
- 2010
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In: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. - : SAGE Publications. - 1718-4304 .- 0896-8608. ; 30:3, s. 336-342
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Journal article (peer-reviewed)abstract
- Inflammation and oxidative stress (OS) are cardiovascular risk factors in patients with chronic kidney disease. N-acetylcysteine (NAC) is a thiol-containing antioxidant with anti-inflammatory properties and has been shown to reduce the number of cardiovascular events in hemodialysis patients. ♦ Methods The current study aimed to determine the effect of oral NAC (2 × 600 mg/daily) on plasma levels of inflammatory and OS markers in peritoneal dialysis (PD) patients. We performed a placebo-controlled study over 8 weeks in 30 patients (40% males, age 52 ± 13 years) on regular PD. Before the study was started, the patients were divided into 2 groups of 15 patients matched for age and gender. 22 patients completed the study (12 on NAC, 10 on placebo). Proinflammatory cytokines [high-sensitivity C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor-alpha, and pentraxin 3] and markers of OS (pentosidine, advanced oxidation protein products, homocysteine, glutathione, asymmetric dimethylarginine, and free sulfhydryls) were measured before and after treatment with NAC. ♦ Results Treatment with NAC for 8 weeks increased mean baseline plasma NAC levels from 2.6 to 24.8 μmol/L ( p = 0.007). This intervention, which caused no side effects, significantly diminished IL-6 levels, from 9.4 (4.5 – 31) to 7.6 (4.9 – 13.5) pg/mL ( p = 0.006), whereas no such changes were observed in the placebo group. NAC treatment did not significantly affect the other inflammatory and OS markers. ♦ Conclusions Short-term oral NAC treatment resulted in reduction of circulating IL-6, suggesting that such treatment could be a useful strategy in blunting the inflammatory response in PD patients.
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- Sjoberg, B, et al.
(author)
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Pentraxin 3, a sensitive early marker of hemodialysis-induced inflammation
- 2012
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In: Blood purification. - : S. Karger AG. - 1421-9735 .- 0253-5068. ; 34:3-4, s. 290-297
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Journal article (peer-reviewed)abstract
- <b><i>Background/Aims:</i></b> The purpose of this investigation was to determine if the long pentraxin 3 (PTX-3) may be a useful marker of intradialytic inflammation since it is rapidly released in the vasculature. <b><i>Methods:</i></b> PTX-3, interleukin-6, tumor necrosis factor-α and C-reactive protein were measured before and during a hemodialysis session in 22 patients and compared with healthy subjects. The effect of dialysis with low-flux, high-flux membranes and hemodiafiltration on the inflammatory response was compared in 11 patients. <b><i>Results:</i></b> C-reactive protein and interleukin-6 levels did not change, while a modest decrease in tumor necrosis factor-α was observed during hemodialysis. The plasma PTX-3 concentration was significantly increased (p < 0.001) after 60 min and peaked at 180 min during hemodialysis. There was no difference in the intradialytic increase in PTX-3 using different dialysis membranes and modalities. <b><i>Conclusion:</i></b> PTX-3 stands out as a rapid and sensitive marker of hemodialysis-induced inflammation. Membrane flux and hemodiafiltration did not alter the inflammatory response.
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