Could there be Haemodynamic Stress Effects on Pro-Inflammatory CD14+CD16+ Monocytes during Convective-Diffusive Treatments? A Prospective Randomized Controlled Trial

Bolasco, Piergiorgio; Spiga, Pierluigi; Arras, Marcella; Murtas, Stefano; Nasa, Giorgio La

doi:10.1159/000494711

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…In addition to differences in clearance of retention solutes, biophysical aspects of the treatment might be relevant as well. This was suggested by a recent trial comparing mixed vs. postdilution HDF [66]. Potentially, the different hemoconcentration and shear stress contributed to the monocyte population distribution.…”

Section: Monocyte Subpopulationsmentioning

confidence: 96%

“…Studies on different dialysis modalities found conflicting results. While online-hemodiafiltration (HDF) was reported to reduce the Mo2 population [66][67][68], this could not be demonstrated for high cut-off hemodialysis [69] in prospective trials. In addition to differences in clearance of retention solutes, biophysical aspects of the treatment might be relevant as well.…”

Section: Monocyte Subpopulationsmentioning

confidence: 99%

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Monocytes in Uremia

Girndt

Trojanowicz

Ulrich

2020

Toxins

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Monocytes play an important role in both innate immunity and antigen presentation for specific cellular immune defense. In patients with chronic renal failure, as well as those treated with maintenance hemodialysis, these cells are largely dysregulated. There is a large body of literature on monocyte alterations in such patients. However, most of the publications report on small series, there is a vast spectrum of different methods and the heterogeneity of the data prevents any meta-analytic approach. Thus, a narrative review was performed to describe the current knowledge. Monocytes from patients with chronic renal failure differ from those of healthy individuals in the pattern of surface molecule expression, cytokine and mediator production, and function. If these findings can be summarized at all, they might be subsumed as showing chronic inflammation in resting cells together with limited activation upon immunologic challenge. The picture is complicated by the fact that monocytes fall into morphologically and functionally different populations and population shifts interact heavily with dysregulation of the individual cells. Severe complications of chronic renal failure such as impaired immune defense, inflammation, and atherosclerosis can be related to several aspects of monocyte dysfunction. Therefore, this review aims to provide an overview about the impairment and activation of monocytes by uremia and the resulting clinical consequences for renal failure patients.

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Section: Monocyte Subpopulationsmentioning

confidence: 96%

Section: Monocyte Subpopulationsmentioning

confidence: 99%

Monocytes in Uremia

Girndt

Trojanowicz

Ulrich

2020

Toxins

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“…The potential role of different dialysis techniques in modulating monocytes' phenotype and function has been investigated with conflicting results. Some authors reported a reduction in the Mo2 population in patients treated with online hemodiafiltration, when compared to standard HD, without differences between pre-, mixed, or post-dilution [61,62].…”

Section: Neutrophils and Monocyte Macrophagesmentioning

confidence: 99%

Immune System Dysfunction and Inflammation in Hemodialysis Patients: Two Sides of the Same Coin

Campo

Lacquaniti

Trombetta

et al. 2022

JCM

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Biocompatibility in hemodialysis (HD) has considerably improved in recent decades, but remains an open issue to be solved, appearing essential to reduce systemic inflammation and enhance patients’ clinical outcomes. Clotting prevention, reduction in complement and leukocyte activation, and improvement of antioxidant effect represent the main goals. This review aims to analyze the different pathways involved in HD patients, leading to immune system dysfunction and inflammation. In particular, we mostly review the evidence about thrombogenicity, which probably represents the most important characteristic of bio-incompatibility. Platelet activation is one of the first steps occurring in HD patients, determining several events causing chronic sub-clinical inflammation and immune dysfunction involvement. Moreover, oxidative stress processes, resulting from a loss of balance between pro-oxidant factors and antioxidant mechanisms, have been described, highlighting the link with inflammation. We updated both innate and acquired immune system dysfunctions and their close link with uremic toxins occurring in HD patients, with several consequences leading to increased mortality. The elucidation of the role of immune dysfunction and inflammation in HD patients would enhance not only the understanding of disease physiopathology, but also has the potential to provide new insights into the development of therapeutic strategies.

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“…Hypercatabolism in dialysis patients is related to intradialytic loss of amino acids as well as cytokine activation [ 91 , 92 ]; interleukin-6 plays a central role in regulating whole-body, muscle and hepatic protein turnover during hemodialysis. CD14 + CD16 + lymphocytes play a central role in the release of cytokines (IL-1 IL-6, TNF-α) [ 93 ]. Furthermore, at the end of the session, a post-dialysis rebound of numerous molecules occurs, the most widely studied of which is urea, largely due to the ease of detection.…”

Section: Nutritional and Therapeutic Interventionsmentioning

confidence: 99%

Hemodialysis—Nutritional Flaws in Diagnosis and Prescriptions. Could Amino Acid Losses Be the Sharpest “Sword of Damocles”?

Bolasco

2020

Nutrients

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This review aims to highlight the strengths and weaknesses emerging from diagnostic evaluations and prescriptions in an intent to prevent progression over time of malnutrition and/or protein-energy wasting (PEW) in hemodialysis (HD) patients. In particular, indications of the most effective pathway to follow in diagnosing a state of malnutrition are provided based on a range of appropriate chemical-clinical, anthropometric and instrumental analyses and monitoring of the nutritional status of HD patients. Finally, based on the findings of recent studies, therapeutic options to be adopted for the purpose of preventing or slowing down malnutrition have been reviewed, with particular focus on protein-calorie intake, the role of oral and/or intravenous supplements and efficacy of some classes of amino acids. A new determining factor that may lead inexorably to PEW in hemodialysis patients is represented by severe amino acid loss during hemodialysis sessions, for which mandatory compensation should be introduced.

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Could there be Haemodynamic Stress Effects on Pro-Inflammatory CD14+CD16+ Monocytes during Convective-Diffusive Treatments? A Prospective Randomized Controlled Trial

Cited by 5 publications

References 31 publications

Monocytes in Uremia

Monocytes in Uremia

Immune System Dysfunction and Inflammation in Hemodialysis Patients: Two Sides of the Same Coin

Hemodialysis—Nutritional Flaws in Diagnosis and Prescriptions. Could Amino Acid Losses Be the Sharpest “Sword of Damocles”?

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