INTERLEUKIN-6 AND INTERLEUKIN-8 IN DIALYSATE AND SERUM FROM PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

We investigated interleukin-6 (IL-6) and interleukin-8 (IL-8) in peritoneal dialysate and serum from 17 patients on continuous ambulatory peritoneal dialysis (CAPD) with a total of 24 episodes of peritonitis and from 14 non-infected CAPD controls. Bacterial growth was found in 20 (83%) of the dialysate samples. Staphylococcus epidermidis caused 40% of the culture-verified peritonitis. Samples from dialysate were obtained during the first month of dialysis and during peritonitis from the first three dialysate bags on day 1 (the day of admittance) and from night bags on days 3 and 10. Serum samples were drawn on days 1 and 10. Interleukin-6 was increased in all dialysate samples on day 1. The peak median concentration was 23,500 pg/ml (range 1,710 to 340,000 pg/mL) in the first dialysate. Interleukin8 was also elevated from all patients in the first dialysate, with a peak median value of 2,000 pg/mL (range, 110 to 185,000 pg/mL). Interleukin-6 and IL-8 concentrations from peritoneal fluid on days 1, 3. and 10 were significantly higher than concentrations from CAPD controls (IL-6 median value, 90 pg/mL, P < 0.001; IL-8 median value, nondetectable, P < 0.001). In serum, IL-6 and IL-8 were detected in 83% and 65% of the episodes, respectively. A correlation (P = 0.007) was seen between IL-6 and IL-8 in the first dialysate sample, but not in the subsequent dialysate samples. The highest acute phase reactant (CRP) level obtained during the peritonitis episode correlated to IL-6 in serum (P < 0.02). CRP was significantly higher in patients infected with virulent bacterial strains compared with patients infected with nonvirulent strains (P < 0.02). In conclusion, our study confirms previous findings that CAPD patients with peritonitis had extremely high dialysate IL-6 concentrations and shows for the first time that dialysate IL-8 levels also were markedly elevated. © 1993, National Kidney Foundation. All rights reserved. All rights reserved.