Microinflammation induces endothelial damage in hemodialysis patients:: the role of convective transport

被引:77
作者
Ramirez, R.
Carracedo, J.
Merino, A.
Nogueras, S.
Alvarez-Lara, M. A.
Rodriguez, M.
Martin-Malo, A.
Tetta, C.
Aljama, P.
机构
[1] Hosp Univ Reina Sofia, Unidad Invest, Serv Nefrol, Cordoba, Spain
[2] Fresenius Med Ctr, Bad Homburg, Germany
关键词
circulating endothelial progenitor cells; endothelial microparticles; inflammation; on-line hemodiafiltration; vascular damage; vascular reparation;
D O I
10.1038/sj.ki.5002250
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Cardiovascular complications are a major cause of mortality in hemodialysis patients. On-line hemofiltration combines convective clearance for removing large solutes with diffusion to remove small solutes and is associated with a significant reduction of inflammation and improved patient survival. We compared on-line hemofiltration to high-flux hemodialysis (HF-HD) in patients in a sequential manner. At baseline, 15 stable patients on HF-HD as compared with five control subjects showed significant increases in CD14+ CD16+ cells, endothelial microparticles, and endothelial progenitor cells ( EPCs). After 4 months of on-line hemofiltration, the number of CD14+ CD16+ cells, microparticles, and EPCs decreased. After returning to HF-HD for 4 months, all measured parameters returned to their respective baseline values. The number of CD14+ CD16+ cells correlated with both endothelial microparticles and EPCs. We conclude that on-line hemofiltration attenuates endothelial dysfunction possibly by decreasing microinflammation. This effect may be directly caused by a modulatory effect of on-line hemofiltration on proinflammatory cells or by a complex interaction that encompasses a wider removal of uremic toxins.
引用
收藏
页码:108 / 113
页数:6
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