Depressed Natural Killer Cell Activity in Uremia

Asaka, Mitsuhiro; Iida, Hiroyuki; Izumino, Kiyoshi; Sasayama, Shígetake

doi:10.1159/000185078

Cited by 50 publications

(8 citation statements)

References 16 publications

(28 reference statements)

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“…Until now, no clear demonstration of the involvement of one or more of these factors has been offered. Especially, T-lymphocyte and natural killer activity have been suggested to play an important role in this item [7,9], but HD treatment does not enhance cellular immunity at all [9] and so, this hypothesis cannot be supported by our data.The work of Yanagisawa and Wade [1] suggests an interesting hypothesis to explain the high incidence of cancer around the moment of induction of H D treatment in our patients. We have not assayed the level of those compounds in the plasma of our patients but the close correlation in time is very suspicious.…”

contrasting

confidence: 75%

Hemodialysis and Cancer

Robles¹,

Calero²,

Rengel³

et al. 1990

Nephron

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Dear Sir, Yanagisawa and Wada [1] recently reported a signifi cant increase in carcinogenic heterocyclic amines in the plasma of patients with uremia just before induction of hemodialysis (HD) treatment. Uremic patients receiving maintenance H D treatment showed lower levels of those compounds and it could not be detected in normal sub jects. Several reports have shown the patients with chronic renal failure exhibit a higher incidence of malig nancy [2-5] and a hypothetical relationship can be sug gested.We reviewed the incidence of malignancies among patients treated with chronic HD in our center between 1977 and 1988. 474 patients were investigated and malig nant neoplasms were diagnosed in 20 cases (4.21%). This indicates a 2.76 times greater risk of suffering from cancer than the general population at the same age [6]. 14 pa tients were males (4.6% of males treated with HD) and 6 were females (3.4% of females treated with HD). The mean age of the patients was 56.2 ± 12.0 years, 9 (45%) of the diagnosed cases were older than 60 years. The age at which the neoplasm was discovered was lower in women than in men (47.6± 15.6 vs. 59.8±8.2 years; p<0.005), with 3 cases younger than 40 years (50%) versus none of the men. Six cases (30%) were diagnosed just before starting HD treatment, 2 more cases were detected less than 6 months after induction of HD treatment, and the rest (n = 12) a long time after beginning dialysis. In 7 (35%) patients the malignancy was detected when the patient had been on HD for more than 5 years. The mean time of uremia before the diagnosis of neoplasm was 51.2 ±38.4 months (2-140 months) and the mean time of treatment with dialysis before detection of cancer was 52.7 ± 37.6 months (5-126 months).Other authors have observed that most of the neo plasms diagnosed in their series were found in the early phase after the induction of HD treatment [4,5]. It is possible that the novice agent works during the period of uremia and it disappears or decreases after H D treatment has begun. Our data also suggest that the agent could persist a long time after HD treatment has been induced, perhaps at a lower concentration, and it could produce the same effect some years later.Several factors could be involved in the pathogenia of the increased incidence of cancer in uremia [2,3,7,8]: T-lymphocyte dysfunction; acquired renal cystic dis ease; etiology of chronic renal failure; the extracorporeal elements used in HD, and increased concentrations of nitrosamines in natural water, among others. Until now, no clear demonstration of the involvement of one or more of these factors has been offered. Especially, T-lymphocyte and natural killer activity have been suggested to play an important role in this item [7,9], but HD treatment does not enhance cellular immunity at all [9] and so, this hypothesis cannot be supported by our data.The work of Yanagisawa and Wade [1] suggests an interesting hypothesis to explain the high incidence of cancer around the moment of induction of H D treatment in our patients. We ha...

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contrasting

confidence: 75%

Hemodialysis and Cancer

Robles¹,

Calero²,

Rengel³

et al. 1990

Nephron

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“…Guanidinosuccinate and guanidinopropionate can inhibit neutrophil superoxide production [30,32] and a mixture of guanidino compounds was found to suppress the natural killer cell response to interleukin-2 [33].…”

Section: Discussionmentioning

confidence: 99%

Guanidino compounds after creatine supplementation in renal failure patients and their relation to inflammatory status

Taes

Marescau

Vriese

et al. 2007

Nephrology Dialysis Transplantation

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Background. Specific guanidino compounds have been described as uraemic toxins and their concentrations are increased in renal failure due to dimished glomerular filtration, whereas the guanidino compound creatine is used as a performance-enhancing substance in athletes. The present study investigates the effects of creatine supplementation on plasma guanidino compounds in a chronic haemodialysis population. Methods. Twenty male haemodialysis patients were included in a placebo-controlled cross-over trial. Patients were treated with creatine (2 g/day) or placebo during two treatment periods of 4 weeks, separated by a washout of 4 weeks. Plasma guanidino compounds and routine biochemical parameters were determined, as well as the prognostic inflammatory and nutritional index (PINI). Results. Upon creatine supplementation, guanidinoacetate concentrations decreased by 15%, due to inhibition of creatine synthesis. Concentrations of α-keto-δ-guanidinovaleric acid increased three-fold and argininic acid concentrations doubled. Guanidinosuccinate concentrations did not change, but correlated inversely with CRP (r = −0.736; P = 0.001), PINI-score (r = −0.716; P = 0.002) and correlated positively with plasma urea concentration (r = 0.54; P = 0.02). Conclusions. Creatine supplementation in haemodialysis patients significantly altered the concentration of specific guanidino compounds. Guanidinosuccinate correlated positively with plasma urea and negatively with inflammation markers.

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“…In uremic patients phagocytosis has been re ported to be normal or slightly diminished [20,21]. Impaired phagocytosis in chronically uremic patients is significantly related to a lower glucose uptake, decreased oxygen con sumption and decreased lactate production by PMNs.…”

Section: Discussionmentioning

confidence: 99%

Influence of Recombinant Human Erythropoietin Therapy on in vivo Chemotaxis and in vitro Phagocytosis of Polymorphonuclear Cells of Hemodialysis Patients

Sperschneider

Neumann²,

Ruffert³

et al. 1996

Blood Purif

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Recombinant human erythropoietin (rhu-EPO) mainly stimulates erythropoiesis, but also influences the production and function of polymorphonuclear granulocytes (PAN). We evaluated the influence of rhu-EPO therapy in patients on maintenance hemodialysis without iron overload on both phagocytic and chemotactic activity of polymorphonuclear leukocytes (PMN) obtained from blood and a skin chamber. The study comprised 28 dialysis patients (15 females, 13 males, age 22-78 years, dialysis sessions three times weekly 4-5 h, mean duration of dialysis treatment 4-99 months) and 20 healthy subjects (9 females, 11 males, age 18-56 years). The absolute number of leukocytes in the peripheral blood, the leukocyte mobilization (chemotactic activity) and the phagocytic activity of PMNs were tested in the patients before (n = 28), and after (n = 18) reaching the target hematocrit of 30% and during the follow-up period. No alteration in the total leukocyte number (PMN, monocytes, lymphocytes) in the peripheral blood during rhu-EPO therapy could be seen. The phagocytic activity of PMNs slightly improved during the follow-up period whereas the decreased chemotactic activity remained unchanged.

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Depressed Natural Killer Cell Activity in Uremia

Cited by 50 publications

References 16 publications

Hemodialysis and Cancer

Hemodialysis and Cancer

Guanidino compounds after creatine supplementation in renal failure patients and their relation to inflammatory status

Influence of Recombinant Human Erythropoietin Therapy on in vivo Chemotaxis and in vitro Phagocytosis of Polymorphonuclear Cells of Hemodialysis Patients

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