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RENAL RESEARCH INSTITUTE SYMPOSIUM: Longitudinal Study of Apoptosis in Chronic Uremic Patients
Author(s) -
D'Intini Vincenzo,
Bordoni Valeria,
Fortunato Antonio,
Galloni Elisabetta,
Carta Mariarita,
Galli Francesco,
Bolgan Irene,
Inguaggiato Paola,
Poulin Sonya,
Bonello Monica,
Tetta Ciro,
Levin Nathan,
Ronco Claudio
Publication year - 2003
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1046/j.1525-139x.2003.16101.x
Subject(s) - medicine , continuous ambulatory peritoneal dialysis , uremia , hemodialysis , peritoneal dialysis , tumor necrosis factor alpha , apoptosis , endocrinology , interleukin 6 , dialysis , gastroenterology , inflammation , biochemistry , chemistry
Uremia is associated with a state of immune dysfunction, increasing infection and malignancy rates. Dysregulation of homeostasis may be directly related to abnormal apoptosis regulation, a process which is crucial for the maintenance of the biologic system. Abnormal apoptosis rates (ARs) have been reported in the literature. We performed a longitudinal study over a 10‐week period in three groups of uremic subjects—hemodialysis (HD), peritoneal dialysis (PD), and predialysis chronic renal failure (CRF). Our results showed that ARs were consistent over the observed period. Monocytes extracted from HD and CRF subjects had higher ARs compared to PD and controls (HD: 26.06 ± 8.82; CRF: 26.96 ± 12.81; PD: 14.77 ± 5.87; C: 11.42 ± 4.60) when placed in culture medium. The plasma of HD and CRF subjects when incubated with U937 cells had a stronger apoptogenic potential compared with PD and controls (HD: 26.08 ± 11.39; CRF: 24.87 ± 9.07; PD: 12.13 ± 4.51; C: 11.69 ± 4.02). Inflammatory markers (C‐reactive protein [CRP], procalcitonin) and cytokines (interleukin [IL]‐1β, IL‐2, IL‐10) had a generally poor correlation except for tumor necrosis factor (TNF)‐α ( p < 0.001). The phagocytic ability of U937 cells when incubated with the various plasma demonstrated impaired response in the HD and CRF subjects (HD: 27.56 ± 6.67; CRF: 30.24 ± 9.08; PD: 36.55 ± 9.80; C: 40.04 ± 6.98). These results suggest continuous renal purification, such as in continuous ambulatory peritoneal dialysis (CAPD), may have advantages over intermittent therapies in regulating apoptosis and maintaining biologic function and homeostasis.